Healthcare Provider Details

I. General information

NPI: 1790212934
Provider Name (Legal Business Name): LENOX VISION CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3393 PEACHTREE RD NE STE B128
ATLANTA GA
30326-1197
US

IV. Provider business mailing address

200 ASHFORD CTR N STE 305
ATLANTA GA
30338-2682
US

V. Phone/Fax

Practice location:
  • Phone: 404-816-1604
  • Fax: 404-816-8574
Mailing address:
  • Phone: 770-727-0772
  • Fax: 770-766-1117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateGA

VIII. Authorized Official

Name: DR. ANISHA E HAJI
Title or Position: CMO, OWNER
Credential: OD
Phone: 470-725-6171