Provider Demographics
NPI:1336170406
Name:CONSOLIDATED VISION GROUP
Entity Type:Organization
Organization Name:CONSOLIDATED VISION GROUP
Other - Org Name:AMERICA'S BEST CONTACTS AND EYEGLASSES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR MANAGED CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MONAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-892-3283
Mailing Address - Street 1:296 GRAYSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10840 LINCOLN TRL
Practice Address - Street 2:
Practice Address - City:FAIRVIEW HGTS
Practice Address - State:IL
Practice Address - Zip Code:62208-2010
Practice Address - Country:US
Practice Address - Phone:618-397-8880
Practice Address - Fax:618-397-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier