Provider Demographics
NPI:1942470505
Name:THE VISION PLACE
Entity Type:Organization
Organization Name:THE VISION PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-929-1627
Mailing Address - Street 1:55 VILCOM CENTER DR
Mailing Address - Street 2:STE 140
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1689
Mailing Address - Country:US
Mailing Address - Phone:919-929-1627
Mailing Address - Fax:
Practice Address - Street 1:55 VILCOM CENTER DR
Practice Address - Street 2:STE 140
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1689
Practice Address - Country:US
Practice Address - Phone:919-929-1627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1449332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1308750001Medicare NSC