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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
1156FX1800XOptician

General Provider Information

NPI Number : 1356893341
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL VISION, INC.
Provider Business Mailing Address
First Line : 2435 COMMERCE AVE
Second Line : BLDG 2200
City : DULUTH
State : GA
Zip : 30096-4980
Country : US
Telephone Number : 800-571-5202
Fax Number :
Provider Business Practice Location Address
First Line : 3240 S COBB DR SE
Second Line : STE 1000
City : SMYRNA
State : GA
Zip : 30080-4194
Country : US
Telephone Number : 770-701-3051
Fax Number : 678-305-0737
Authorized Official
Title or Position : MANAGED CARE
Name : ERIC ANTOINE
Credential :
Telephone Number : 678-892-3771
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/26/2016

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