Basic Information
| Provider Information | |||||||||
| NPI: | 1447282983 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CONSOLIDATED VISION GROUP | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | AMERICA'S BEST CONTACTS AND EYEGLASSES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 296 GRAYSON HWY | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300465737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708223600 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 14010 E MISSISSIPPI AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800123693 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037514500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 06/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | EDICK | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MC ASSISTANT | ||||||||
| AuthorizedOfficialTelephone: | 6788923774 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NATIONAL VISION INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.