Provider Demographics
NPI:1689873648
Name:VISION WORKS, INC.
Entity Type:Organization
Organization Name:VISION WORKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:RDO
Authorized Official - Phone:508-824-9962
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-0589
Mailing Address - Country:US
Mailing Address - Phone:508-824-9962
Mailing Address - Fax:
Practice Address - Street 1:302 BROADWAY UNIT 4
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1439
Practice Address - Country:US
Practice Address - Phone:508-824-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4368332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1533967Medicaid