Healthcare Provider Details

I. General information

NPI: 1770527418
Provider Name (Legal Business Name): NATIONAL VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

A STREET BLDG 504
MCCHORD AFB WA
98438
US

IV. Provider business mailing address

PO BOX 951336
DALLAS TX
75395-1336
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-1721
  • Fax:
Mailing address:
  • Phone:
  • 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: CARLY SCHENCK
Title or Position: MANAGER, MANAGED CARE SALES
Credential:
Phone: 678-892-3760