Provider Demographics
NPI:1467527770
Name:20-20 EYECARE OF VIRGINIA INC
Entity Type:Organization
Organization Name:20-20 EYECARE OF VIRGINIA INC
Other - Org Name:20-20 EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-827-1223
Mailing Address - Street 1:5200 W MERCURY BLVD
Mailing Address - Street 2:SUITE 136
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-1445
Mailing Address - Country:US
Mailing Address - Phone:757-827-1223
Mailing Address - Fax:757-827-1285
Practice Address - Street 1:4640 MONTICELLO AVE STE 8A
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-8230
Practice Address - Country:US
Practice Address - Phone:757-258-1020
Practice Address - Fax:757-229-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0005788118OtherAETNA
VA253757OtherANTHEM
VA253757OtherANTHEM
VA0835460005Medicare NSC