Provider Demographics
NPI:1609822790
Name:EYES-RITE,INC
Entity Type:Organization
Organization Name:EYES-RITE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:770-938-9170
Mailing Address - Street 1:3983 LAVISTA RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-5153
Mailing Address - Country:US
Mailing Address - Phone:770-938-9170
Mailing Address - Fax:770-270-9025
Practice Address - Street 1:3983 LAVISTA RD
Practice Address - Street 2:SUITE 125
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5153
Practice Address - Country:US
Practice Address - Phone:770-938-9170
Practice Address - Fax:770-270-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA00001360156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0682290001Medicare ID - Type UnspecifiedPROVIDER #