Provider Demographics
NPI:1487831756
Name:CHARLES L NORTON
Entity Type:Organization
Organization Name:CHARLES L NORTON
Other - Org Name:TRI-CITY OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNAO
Authorized Official - Phone:276-523-2889
Mailing Address - Street 1:512 POWELL AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-2346
Mailing Address - Country:US
Mailing Address - Phone:276-523-2889
Mailing Address - Fax:276-523-4488
Practice Address - Street 1:512 POWELL AVE E
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-2346
Practice Address - Country:US
Practice Address - Phone:276-523-2889
Practice Address - Fax:276-523-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101000533332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5626190001Medicare NSC