Provider Demographics
NPI:1255488813
Name:NATIONAL VISION, INC.
Entity Type:Organization
Organization Name:NATIONAL VISION, INC.
Other - Org Name:AMERICA'S BEST CONTACTS & EYEGLASSES #5501
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MC ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-892-3774
Mailing Address - Street 1:296 GRAYSON HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-5737
Mailing Address - Country:US
Mailing Address - Phone:800-571-5202
Mailing Address - Fax:
Practice Address - Street 1:6055 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2512
Practice Address - Country:US
Practice Address - Phone:815-394-7412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL VISION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-05
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier