Provider Demographics
NPI:1740625268
Name:ARC VISION FACILITIES LLC
Entity type:Organization
Organization Name:ARC VISION FACILITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROBATEAU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:404-228-6865
Mailing Address - Street 1:3176 ESPLANADE CIR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-4221
Mailing Address - Country:US
Mailing Address - Phone:404-228-6865
Mailing Address - Fax:
Practice Address - Street 1:3176 ESPLANADE CIR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-4221
Practice Address - Country:US
Practice Address - Phone:404-228-6865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty