NPI 1861728800 · live from the CMS NPI Registry
Bella Vista Family Eyecare
Optometrist in Lithia Springs, GA. National Provider Identifier 1861728800, active.
NPI record
| NPI | 1861728800 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1100 Thornton Rd, Lithia Springs, GA 30122 |
| Practice phone | 770-819-4981 |
| Mailing address | 3142 Brians Creek Dr Se, Conyers, GA 30013 |
| Enumerated | October 27, 2009 |
| Last updated | October 27, 2009 |
| Authorized official | Samantha Mills, Owner/Optometrist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | OPC4189 (FL) |
| Optometrist primary | 152W00000X | OPT002269 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.