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VICTORY VISION PC NPI 1386872331


NPI Information

NPI: 1386872331
Provider Name: VICTORY VISION PC
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
3507 MANCHESTER EXPY
UNIT 92
COLUMBUS, GA
ZIP 31909
Phone: (706) 327-0111
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VICTORY VISION PC is a point of service in Columbus, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. VICTORY VISION PC NPI is 1386872331. The provider is registered as an organization entity type.

The provider's business location address is:

3507 MANCHESTER EXPY
UNIT 92
COLUMBUS, GA
ZIP 31909-400
Phone: (706) 327-0111
Fax: (706) 327-4980

The provider's authorized official is David Rossello .
The authorized official title is President and has the following contact phone number (215) 833-3465.

The enumeration date for this NPI number is 6/29/2009 and was last updated on 7/15/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1302R00000XHealth Maintenance OrganizationGA 002439GEORGIANo
2305R00000XPreferred Provider OrganizationGA 002439GEORGIANo
3305S00000XPoint of ServiceGA 002439GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1V06677MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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