Provider Demographics
NPI:1992203665
Name:HELIOS VISION GROUP, INC.
Entity Type:Organization
Organization Name:HELIOS VISION GROUP, INC.
Other - Org Name:WAL-MART VISION CENTER #5285
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FCOVD
Authorized Official - Phone:440-336-1185
Mailing Address - Street 1:10139 ROYALTON RD STE D
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-4473
Mailing Address - Country:US
Mailing Address - Phone:330-915-3007
Mailing Address - Fax:
Practice Address - Street 1:3200 ATLANTIC BLVD NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44705-3933
Practice Address - Country:US
Practice Address - Phone:330-489-9145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty