| |
33 W Main St, Berryville, VA 22611-1340 | |
(540) 955-5051 | |
(540) 955-5052 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 33 W Main St, Berryville, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477842763 | NPI | - | NPPES |
6502970001 | Other | VA | DME NSC PTAN |
9232397 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0618000137 (Virginia) | Primary |
332H00000X | Eyewear Supplier | 0618000137 (Virginia) | Secondary |
Mailing Address | Practice Location Address |
---|---|
33 W Main St, Berryville, VA 22611-1340 Ph: (540) 955-5051 | 33 W Main St, Berryville, VA 22611-1340 Ph: (540) 955-5051 |