Provider Demographics
NPI:1942248307
Name:DAVID L RICH, OD AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:DAVID L RICH, OD AND ASSOCIATES, INC
Other - Org Name:RICH VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-325-3400
Mailing Address - Street 1:2484 BRIARCLIFF RD NE
Mailing Address - Street 2:STE 39
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3011
Mailing Address - Country:US
Mailing Address - Phone:404-325-3400
Mailing Address - Fax:404-325-3477
Practice Address - Street 1:2484 BRIARCLIFF RD NE
Practice Address - Street 2:STE 39
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3011
Practice Address - Country:US
Practice Address - Phone:404-325-3400
Practice Address - Fax:404-325-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001956152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G702402Medicare PIN