1124347034 NPI number — HARMAN EYE CENTER OF BEDFORD OPTICAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124347034 NPI number — HARMAN EYE CENTER OF BEDFORD OPTICAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARMAN EYE CENTER OF BEDFORD OPTICAL
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:
1124347034
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1290
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOREST
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24551-1290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-385-5600
Provider Business Mailing Address Fax Number:
434-455-7172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
815 SUMMIT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24523-2636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-425-7900
Provider Business Practice Location Address Fax Number:
434-455-7172
Provider Enumeration Date:
05/18/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MAYS
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
INSURANCE MANAGER
Authorized Official Telephone Number:
434-385-5600

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X , with the licence number:  PENDING , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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