Healthcare Provider Details

I. General information

NPI: 1285647891
Provider Name (Legal Business Name): FRIEDRICHS FAMILY EYE CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 NORTH MAIN STREET
CHATHAM VA
24531-0943
US

IV. Provider business mailing address

PO BOX 943
CHATHAM VA
24531-0943
US

V. Phone/Fax

Practice location:
  • Phone: 434-432-1500
  • Fax: 434-432-1500
Mailing address:
  • Phone: 434-432-1500
  • Fax: 434-432-1500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618001415
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618001335
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000917
License Number StateVA

VIII. Authorized Official

Name: DR. GRAY W. FRIEDRICHS
Title or Position: OWNER
Credential: O.D.
Phone: 434-432-1500