Southeastern Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

SOUTHEASTERN OPTICAL, INC.

Practice address

6490 Commonwealth Dr
Roanoke, VA 24018-5159

Phone

(540) 989-8644

Fax

(540) 772-0074

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Telcher

Title

General Manager

Phone

(540) 989-8644

Specialties & licenses 1

Addresses

Other names 1

• Carl Zeiss Vision Other name

Locations

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669680799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6490 COMMONWEALTH DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185159",
            "telephone_number": "540-989-8644",
            "fax_number": "540-772-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 COMMONWEALTH DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185159",
            "telephone_number": "540-989-8644",
            "fax_number": "540-772-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TELCHER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "540-989-8644",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carl Zeiss Vision",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Sarah Southard, NP
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• Eyewear Supplier in Roanoke, VA
• Providers in Roanoke, 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.