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NPI Code Detail

MEDICARE: NATIONAL VISION INC

MEDICARE: NATIONAL VISION INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1346919354
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL VISION INC
Provider Business Mailing Address
First Line : 2435 COMMERCE AVE
Second Line :
City : DULUTH
State : GA
Zip : 30096-4980
Country : US
Telephone Number : 800-571-5202
Fax Number :
Provider Business Practice Location Address
First Line : 1722 APPLE GLEN BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1725
Country : US
Telephone Number : 260-702-4850
Fax Number :
Authorized Official
Title or Position : MANAGED CARE STORE ENROLLMENT
Name : JULIE GARRISON
Credential :
Telephone Number : 770-822-3600
Provider Enumeration Date : 09/13/2021
Last Update Date : 09/13/2021

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