Provider Demographics
NPI:1700259249
Name:ADVANCED VISION CARE NETWORK, INC
Entity Type:Organization
Organization Name:ADVANCED VISION CARE NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:401-438-4447
Mailing Address - Street 1:400 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02914-3826
Mailing Address - Country:US
Mailing Address - Phone:401-438-4447
Mailing Address - Fax:401-438-0160
Practice Address - Street 1:400 WARREN AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-3826
Practice Address - Country:US
Practice Address - Phone:401-438-4447
Practice Address - Fax:401-438-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty