| Organization Name: | VIRTUAL IMAGE EYEWEAR PC |
| NPI Number: | 1639204720 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EARL E LANTER (PRESEIDENT) |
| Mailing Address: | 5025 E 82nd St Ste 2300 Indianapolis |
| State: | IN US |
| Postal Code: | 46250 |
| Phone Number: | 3178446269 |
| Fax Number: | 3178157567 |
| NPI Enumeration Date: | 02/22/2007 |
| NPI Last Update Date: | 04/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | 0111609909 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |