1528463981 NPI number — CENTURY VISION CENTER, CHTD.

Table of content: (NPI 1528463981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528463981 NPI number — CENTURY VISION CENTER, CHTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTURY VISION CENTER, CHTD.
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:
1528463981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8230 W SAHARA AVE
Provider Second Line Business Mailing Address:
STE 121
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89117-8959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-877-3937
Provider Business Mailing Address Fax Number:
702-877-3935

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10870 W. CHARLESTON BLVD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-877-3937
Provider Business Practice Location Address Fax Number:
702-877-3935
Provider Enumeration Date:
10/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CRUTCHFIELD
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/OPTOMETRIST
Authorized Official Telephone Number:
702-944-2001

Provider Taxonomy Codes

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

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





Copyright © 2007-2025 www.npivalidator.com