Provider Demographics
NPI:1578654026
Name:HARMAN EYE CENTER OF LYNCHBURG, LLC
Entity Type:Organization
Organization Name:HARMAN EYE CENTER OF LYNCHBURG, LLC
Other - Org Name:LYNCHBURG EYE PHYSICIANS & SURGEONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-385-5600
Mailing Address - Street 1:PO BOX 1290
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1290
Mailing Address - Country:US
Mailing Address - Phone:434-385-5600
Mailing Address - Fax:434-455-7172
Practice Address - Street 1:2108 LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1424
Practice Address - Country:US
Practice Address - Phone:434-845-2020
Practice Address - Fax:434-845-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101019273207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0000000001677OtherANTHEM
CL1134OtherRAILROAD MEDICARE
VAC10482Medicare PIN
VA0000000001677OtherANTHEM
VA6159160001Medicare NSC
C00063Medicare PIN
CL1134OtherRAILROAD MEDICARE
VA00X701H01Medicare PIN
VA00X702H02Medicare PIN
VAI49946Medicare UPIN