Vistar Eye Center
Organization Active NPI Eyewear Supplier · Roanoke, VA
NPI 1003050485 · NPPES record last updated Jul 23, 2009
Key facts
- NPI
- 1003050485
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- License
- 3699 (VA)
- Legal business name
- VISTAR EYE CENTER
- Practice address
- 70 Summerfield CT
Roanoke, VA 24019-4579 - Phone
- (540) 855-5139
- Fax
- (540) 342-4373
- NPI assigned
- Apr 29, 2009
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kathy P Cowan
- Title
- Administrator
- Phone
- (540) 855-5123
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 7
Practitioners 29
-
Chad Albright, MD
-
Emma-Catherine Hix Ali, O.D.
-
Megan M Andrews, O.D.
-
Timothy R Byrnes, MD
-
Frank Cotter, M.D.
-
Reagan Darner, OD
-
Justin Harvey, MD
-
Anna Mackin, M.D.
-
Kristen Marie Piery, O.D.
-
Tad Douglas Schoedel, M.D.
-
Donald Mac Scothorn, O.D.
-
Bryan Andrew Strelow, M.D., M.A.
-
Joseph Stuart Tims, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930002494 | VA | DME Supplier - Physician - Optometrist | 0446249858 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Roanoke, VA |
| O20100930082508 | VA | DME Supplier - Physician - Optometrist | 0446249858 | Practice locations: Roanoke, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | 3699 | VA | Yes |
Addresses
Primary practice location
70 Summerfield CT
Roanoke, VA 24019-4579
Mailing address
PO Box 1789
Roanoke, VA 24008-1789
Phone (540) 855-5139
Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.