Basic Information
| Provider Information | |||||||||
| NPI: | 1447641071 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL VISION, INC. | ||||||||
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| OtherOrganizationName: | EYEGLASS WORLD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2435 COMMERCE AVE | ||||||||
| Address2: | BLDG 2200 | ||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300964980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7708223600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6667 ORCHARD LAKE RD | ||||||||
| Address2: | B200 | ||||||||
| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483223404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488629670 | ||||||||
| FaxNumber: | 2487370519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2015 | ||||||||
| LastUpdateDate: | 02/18/2015 | ||||||||
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| AuthorizedOfficialLastName: | VAUGHN | ||||||||
| AuthorizedOfficialFirstName: | LEAHANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGED CARE SALES COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 4704482782 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156FX1800X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.