Lake Drive Opticians

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1101000159 Issued in VA

Legal business name

LAKE DRIVE OPTICIANS

Practice address

224 S Pollard St
Vinton, VA 24179-2530

Phone

(540) 345-0111

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By 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

Mr. William David Thomas

Title

Owner/Optician

Phone

(540) 345-0111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1760647408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S POLLARD ST",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241792530",
            "telephone_number": "540-345-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S POLLARD ST",
            "city": "VINTON",
            "state": "VA",
            "postal_code": "241792530",
            "telephone_number": "540-345-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE DRIVE OPTICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/OPTICIAN",
        "authorized_official_telephone_number": "540-345-0111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "VA",
            "license": "1101000159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.