Provider Demographics
NPI:1033811104
Name:ATHENS VISION CENTERS, LLC
Entity Type:Organization
Organization Name:ATHENS VISION CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN HENRY
Authorized Official - Middle Name:BO
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-433-2031
Mailing Address - Street 1:105 TRINITY PL
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-2112
Mailing Address - Country:US
Mailing Address - Phone:706-549-9993
Mailing Address - Fax:706-549-4047
Practice Address - Street 1:17 S THOMAS ST
Practice Address - Street 2:
Practice Address - City:ELBERTON
Practice Address - State:GA
Practice Address - Zip Code:30635-2453
Practice Address - Country:US
Practice Address - Phone:706-549-9993
Practice Address - Fax:706-549-4047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KELLER, CRYMES, & DEMARCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies