Vistar Eye Center

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1156 Issued in VA

Legal business name

VISTAR EYE CENTER

Practice address

548 Blue Ridge Ave
Bedford, VA 24523-2604

Phone

(540) 855-5139

Fax

(540) 342-4373

NPI assigned

Apr 29, 2009

Last updated

Apr 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kathy P Cowan

Title

Administrator

Phone

(540) 855-5123

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1740424126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240081789",
            "telephone_number": "540-855-5139",
            "fax_number": "540-342-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 BLUE RIDGE AVE",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245232604",
            "telephone_number": "540-855-5139",
            "fax_number": "540-342-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAR EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "COWAN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "540-855-5123",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "VA",
            "license": "1156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.