Provider Demographics
NPI:1114939378
Name:FRIEDRICHS FAMILY EYE CENTER PC
Entity Type:Organization
Organization Name:FRIEDRICHS FAMILY EYE CENTER PC
Other - Org Name:FRIEDRICHS FAMILY EYE CENTER OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRIEDRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:276-647-3937
Mailing Address - Street 1:1975 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-8388
Mailing Address - Country:US
Mailing Address - Phone:276-647-3937
Mailing Address - Fax:
Practice Address - Street 1:1975 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-8388
Practice Address - Country:US
Practice Address - Phone:276-647-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000917152W00000X
VA0618001415152W00000X
VA0618001335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010108641Medicaid
VA1093800781OtherCHRISTAIN NPI
VA1114928934OtherDR. BUTTERWORTH'S NPI
1568515666OtherNPI - DR. HARPIN
VA1174526008OtherDR. FRIEDRICHS' NPI
VA010063272Medicaid
VA010070155Medicaid
VAV00107Medicare UPIN
VA010063272Medicaid
1114939378Medicare Oscar/Certification
1568515666OtherNPI - DR. HARPIN
VA1326700001Medicare NSC
C06500Medicare PIN