| Organization Name: | FAMILY VISION CARE OPHTHALMIC DISPENSING LLC |
| NPI Number: | 1053335695 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN E HALSTEAD (OWNER) |
| Mailing Address: | 205 Lake Ave Saratoga Springs |
| State: | NY US |
| Postal Code: | 128662628 |
| Phone Number: | 5185846111 |
| Fax Number: | 5185808589 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 10/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |