1801839972 NPI number — NATIONAL VISION, INC.

Table of content: (NPI 1801839972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801839972 NPI number — NATIONAL VISION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL VISION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801839972
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2435 COMMERCE AVE BLDG 2200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DULUTH
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30096-4980
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
470-448-2782
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
980 N SUSQUEHANNA TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SELINSGROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17870-7766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-374-8381
Provider Business Practice Location Address Fax Number:
570-374-8473
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VAUGHN
Authorized Official First Name:
LEAHANN
Authorized Official Middle Name:
RENE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
470-448-2782

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)