Basic Information
Provider Information
NPI: 1427447531
EntityType: 2
ReplacementNPI:  
OrganizationName: NATIONAL VISION, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AMERICA'S BEST CONTACTS & EYEGLASSES
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 296 GRAYSON HWY
Address2:  
City: LAWRENCEVILLE
State: GA
PostalCode: 300465737
CountryCode: US
TelephoneNumber: 7708223600
FaxNumber:  
Practice Location
Address1: 460 CHEROKEE PL
Address2:  
City: CARTERSVILLE
State: GA
PostalCode: 301212963
CountryCode: US
TelephoneNumber: 6785355180
FaxNumber: 7703838936
Other Information
ProviderEnumerationDate: 01/13/2015
LastUpdateDate: 01/13/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: VAUGHN
AuthorizedOfficialFirstName: LEAHANN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: MANAGED CARE SALES COORDINATOR
AuthorizedOfficialTelephone: 4704482782
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
156FX1800X  Y193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersTechnician/TechnologistOptician

No ID Information.


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