Provider Demographics
NPI:1134506983
Name:ONE WORLD OPTICAL BUSINESS L.L.C.
Entity Type:Organization
Organization Name:ONE WORLD OPTICAL BUSINESS L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABOC/LICENSED OPTICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHMIRZADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-382-8207
Mailing Address - Street 1:1076 GABLES DR
Mailing Address - Street 2:APT 207
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-4755
Mailing Address - Country:US
Mailing Address - Phone:434-382-8207
Mailing Address - Fax:434-266-0078
Practice Address - Street 1:105A TRADEWYND DR
Practice Address - Street 2:SUITE 3
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3112
Practice Address - Country:US
Practice Address - Phone:434-382-8207
Practice Address - Fax:434-266-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101003537156FX1800X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty