Provider Demographics
NPI:1912504846
Name:NATIONAL VISION INC
Entity Type:Organization
Organization Name:NATIONAL VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE SALES
Authorized Official - Prefix:
Authorized Official - First Name:LEAHANN
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-448-2782
Mailing Address - Street 1:2435 COMMERCE AVE BLDG 2200
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4980
Mailing Address - Country:US
Mailing Address - Phone:800-637-3597
Mailing Address - Fax:
Practice Address - Street 1:1025 VILLAGE CENTER DR STE 1
Practice Address - Street 2:
Practice Address - City:TARENTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-3840
Practice Address - Country:US
Practice Address - Phone:724-715-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty