Provider Demographics
NPI:1205202702
Name:EMPIRE VISION CENTER, INC
Entity Type:Organization
Organization Name:EMPIRE VISION CENTER, INC
Other - Org Name:VISIONWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, RETAIL MANAGED CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-524-6515
Mailing Address - Street 1:PO BOX 418348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8348
Mailing Address - Country:US
Mailing Address - Phone:800-349-5120
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:273 LOUDON ROAD
Practice Address - Street 2:SUITE 7
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-0418
Practice Address - Fax:603-224-0398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier