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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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1407803653
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATIONAL VISION, INC.
Provider Business Mailing Address
First Line : PO BOX 951336
Second Line :
City : DALLAS
State : TX
Zip : 75395-1336
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5450 NEW HOPE COMMONS DR
Second Line :
City : DURHAM
State : NC
Zip : 27707-9716
Country : US
Telephone Number : 919-489-4156
Fax Number :
Authorized Official
Title or Position : PROVIDER NETWORK ADMINISTRATOR
Name : ANNA PURCELL
Credential :
Telephone Number : 770-822-4245
Provider Enumeration Date : 05/30/2006
Last Update Date : 06/16/2008

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