Provider Demographics
NPI:1477732113
Name:BETTER VISION EYEGLASS CENTER
Entity Type:Organization
Organization Name:BETTER VISION EYEGLASS CENTER
Other - Org Name:TIDEWATER EYE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE / BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CMOM, CMIS
Authorized Official - Phone:757-397-7858
Mailing Address - Street 1:3601 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3103
Mailing Address - Country:US
Mailing Address - Phone:757-397-2020
Mailing Address - Fax:
Practice Address - Street 1:3601 COUNTY ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3103
Practice Address - Country:US
Practice Address - Phone:757-397-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001506332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1276560003Medicare NSC