1356893341 NPI number — NATIONAL VISION, INC.

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 1356893341 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:
6
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:
1356893341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2435 COMMERCE AVE
Provider Second Line Business Mailing Address:
BLDG 2200
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:
800-571-5202
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3240 S COBB DR SE
Provider Second Line Business Practice Location Address:
STE 1000
Provider Business Practice Location Address City Name:
SMYRNA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30080-4194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-701-3051
Provider Business Practice Location Address Fax Number:
678-305-0737
Provider Enumeration Date:
10/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ANTOINE
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGED CARE
Authorized Official Telephone Number:
678-892-3771

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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