Provider Demographics
NPI:1912160656
Name:NEW VISION EYEWEAR
Entity Type:Organization
Organization Name:NEW VISION EYEWEAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-891-1988
Mailing Address - Street 1:3434 PRYTANIA ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3532
Mailing Address - Country:US
Mailing Address - Phone:504-891-1988
Mailing Address - Fax:504-899-1895
Practice Address - Street 1:3434 PRYTANIA ST
Practice Address - Street 2:SUITE 250
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3532
Practice Address - Country:US
Practice Address - Phone:504-891-1988
Practice Address - Fax:504-899-1895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW VISION EYEWEAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4514870002Medicare PIN
LA1242920001Medicare PIN