Provider Demographics
NPI:1023261781
Name:DUBLIN VISION CARE INC
Entity type:Organization
Organization Name:DUBLIN VISION CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRASWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-272-2303
Mailing Address - Street 1:714 BELLEVUE AVENUE
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021
Mailing Address - Country:US
Mailing Address - Phone:478-272-2303
Mailing Address - Fax:478-275-1575
Practice Address - Street 1:714 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4846
Practice Address - Country:US
Practice Address - Phone:478-272-2303
Practice Address - Fax:478-275-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0975332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00230271A3Medicaid
GA0323340001Medicare NSC
GAU22838Medicare UPIN