Healthcare Provider Details

I. General information

NPI: 1700824133
Provider Name (Legal Business Name): NATIONAL VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 GRANDVIEW DR
SIMPSONVILLE SC
29680-3163
US

IV. Provider business mailing address

2435 COMMERCE AVE BLDG 2200
DULUTH GA
30096-4980
US

V. Phone/Fax

Practice location:
  • Phone: 864-963-6168
  • Fax:
Mailing address:
  • Phone: 800-571-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: LEAHANN VAUGHN
Title or Position: MANAGED CARE SALES COORDINATOR
Credential:
Phone: 470-448-2782