Springfield Mall Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

736363 Issued in VA

Legal business name

SPRINGFIELD MALL OPTICAL, INC.

Practice address

6795 Springfield Mall
Springfield, VA 22150-1704

Phone

(703) 971-6026

Fax

(703) 971-8695

NPI assigned

Mar 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ana D Puhl

Title

Vice President

Phone

(703) 971-6026

Specialties & licenses 1

Addresses

Other names 1

• Sterling Optical Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184744310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 HOWARD AVE STE 301B",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822611",
            "telephone_number": "703-761-9504",
            "fax_number": "701-761-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6795 SPRINGFIELD MALL",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221501704",
            "telephone_number": "703-971-6026",
            "fax_number": "703-971-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD MALL OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PUHL",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "703-971-6026",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "VA",
            "license": "736363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sterling Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Springfield, VA
• Providers in Springfield, VA by specialty
• Eyewear Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.