Basic Information
| Provider Information | |||||||||
| NPI: | 1720571615 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL VISION, INC. | ||||||||
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| OtherOrganizationName: | AMERICA'S BEST CONTACTS & EYEGLASSES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2435 COMMERCE AVE BLDG 2200 | ||||||||
| Address2: | |||||||||
| City: | DULUTH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300964980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005715202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6931 GRAND AVE STE E2 | ||||||||
| Address2: | |||||||||
| City: | GURNEE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600311610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474065542 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2018 | ||||||||
| LastUpdateDate: | 06/14/2018 | ||||||||
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| AuthorizedOfficialLastName: | MATOS | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGED CARE SALES COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 6788923771 | ||||||||
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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.