Provider Demographics
NPI:1578732574
Name:WILLIAM FURROW
Entity Type:Organization
Organization Name:WILLIAM FURROW
Other - Org Name:ACCENT OPTICIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:FURROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-236-4673
Mailing Address - Street 1:952 E STUART DR
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2422
Mailing Address - Country:US
Mailing Address - Phone:276-236-4673
Mailing Address - Fax:276-238-0919
Practice Address - Street 1:952 E STUART DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2422
Practice Address - Country:US
Practice Address - Phone:276-236-4673
Practice Address - Fax:276-238-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101001847332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4685630001Medicare NSC