Provider Demographics
NPI:1588833222
Name:WARRENS OPTICAL CO INC
Entity Type:Organization
Organization Name:WARRENS OPTICAL CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:REG VA OPTICIAN
Authorized Official - Phone:804-282-2423
Mailing Address - Street 1:7019 THREE CHOPT ROAD STE D
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3600
Mailing Address - Country:US
Mailing Address - Phone:804-282-2423
Mailing Address - Fax:
Practice Address - Street 1:7019 THREE CHOPT ROAD STE D
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3600
Practice Address - Country:US
Practice Address - Phone:804-282-2423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA415156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0163780001Medicare PIN
0163780001Medicare NSC