Healthcare Provider Details
I. General information
NPI: 1194149567
Provider Name (Legal Business Name): AMERICA'S BEST CONTACTS & EYEGLASSES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2014
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3210 LACLEDE STATION RD
ST. LOUIS MO
63143
US
IV. Provider business mailing address
296 GRAYSON HWY
LAWRENCEVILLE GA
30046-5737
US
V. Phone/Fax
- Phone: 314-646-8892
- Fax: 314-646-0008
- Phone: 770-822-3600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LEAHANN
VAUGHN
Title or Position: MANAGED CARE COORDINATOR
Credential:
Phone: 770-822-3600