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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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407894306
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 : 6438 BASILE ROWE
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-3900
Country : US
Telephone Number : 315-463-8862
Fax Number :
Authorized Official
Title or Position : PROVIDER NETWORK ADMINISTRATOR
Name : ANNA PURCELL
Credential :
Telephone Number : 770-822-4245
Provider Enumeration Date : 06/03/2006
Last Update Date : 08/22/2020

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