Organization Name: | NATIONWIDE VISION CENTER, INC. |
NPI Number: | 1528468303 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VINCENT HAYES (VP MANAGED CARE) |
Mailing Address: | 85 W Combs Rd Suite 108 San Tan Valley |
State: | AZ US |
Postal Code: | 851409105 |
Phone Number: | 4809611865 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2014 |
NPI Last Update Date: | 08/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1311E |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |