| Organization Name: | NATIONWIDE VISION CENTER, INC. |
| NPI Number: | 1053765370 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VINCENT HAYES (VP MANAGED CARE) |
| Mailing Address: | 5405 E Granite St Bldg. 2527 Davis Monthan Afb |
| State: | AZ US |
| Postal Code: | 857073004 |
| Phone Number: | 5207455669 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2016 |
| NPI Last Update Date: | 04/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |