Provider Demographics
NPI: | 1598957599 |
---|---|
Name: | NATIONAL VISION, INC. |
Entity Type: | Organization |
Organization Name: | NATIONAL VISION, INC. |
Other - Org Name: | AMERICA'S BEST CONTACTS & EYEGLASSES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PROVIDER NETWORK MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LEAHANN |
Authorized Official - Middle Name: | RENE |
Authorized Official - Last Name: | VAUGHN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 470-448-2782 |
Mailing Address - Street 1: | 2435 COMMERCE AVE BLDG 2200 |
Mailing Address - Street 2: | |
Mailing Address - City: | DULUTH |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30096-4980 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 470-448-2782 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 916 LARGO CENTER DR |
Practice Address - Street 2: | SUITE B-23 |
Practice Address - City: | UPPER MARLBORO |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20774-3704 |
Practice Address - Country: | US |
Practice Address - Phone: | 240-492-0253 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-08-14 |
Last Update Date: | 2019-04-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |