| Crater Vision Inc | |
|
3333 S Crater Rd Ste 2d, Petersburg, VA 23805-9276 | |
| (804) 732-3937 | |
| (807) 733-6005 |
| Full Name | Crater Vision Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 3333 S Crater Rd Ste 2d, Petersburg, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497935829 | NPI | - | NPPES |
| 009235221 | Medicaid | VA | |
| 080634 | Other | VA | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Mark E Moore |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730289935 PECOS PAC ID: 2264545839 Enrollment ID: I20120301000144 |
| Mailing Address | Practice Location Address |
|---|---|
| Crater Vision Inc 3333 S Crater Rd Ste 2d, Petersburg, VA 23805-9276 Ph: (804) 732-3937 | Crater Vision Inc 3333 S Crater Rd Ste 2d, Petersburg, VA 23805-9276 Ph: (804) 732-3937 |
Legacy Eye Care Optometrist Medicare: Medicare Enrolled Practice Location: 3500 S Crater Rd, Petersburg, VA 23805 Phone: 804-861-2020 Fax: 804-861-2115 | |
Dr. Ajit D Tiwari, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 300 S Sycamore St, Petersburg, VA 23803 Phone: 804-732-5481 Fax: 804-732-8675 | |
Marron, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 49 Morton Ave, Petersburg, VA 23805 Phone: 804-732-2020 Fax: 804-732-0470 | |
Petersburg Family Eye Care Optometrist Medicare: Medicare Enrolled Practice Location: 44 Medical Park Blvd, Ste H, Petersburg, VA 23805 Phone: 804-898-3373 Fax: 804-479-3775 | |
Ajit D. Tiwari, O.d. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 300 S Sycamore St, Petersburg, VA 23803 Phone: 804-732-5481 | |
Dr. Robert Joaquin Foster, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 3500 S Crater Rd, Petersburg, VA 23805 Phone: 804-861-2020 Fax: 804-861-2115 |