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General NPI Number Information
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NPI Number | 1386790152
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Entity Type | Organization
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Legal Business Name | NATIONAL VISION, INC.
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 01/02/2010
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Provider Practice Location Address
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Address Line | 4001 EAST 1ST STREET (US 41)
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City | BRADENTON
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State | FL
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Zip | 34208
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Country | US
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Telephone | 941-745-9800
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Fax | 941-749-2863
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Provider Business Mailing Address
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Address Line | 296 GRAYSON HIGHWAY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 770-822-3600
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Fax |
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Authorized Official
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Title or Position | SR. VICE PRESIDENT, PROFESSIONAL SE
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Name | MR. ROBERT W. STEIN
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Credential |
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Telephone | 770-822-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OE1430
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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