Provider Demographics
NPI:1063561108
Name:QUALITY VISION CENTER, INC.
Entity type:Organization
Organization Name:QUALITY VISION CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOBERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-333-2929
Mailing Address - Street 1:2350 SE WASHINGTON BLVD STE 228
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-7211
Mailing Address - Country:US
Mailing Address - Phone:918-333-2929
Mailing Address - Fax:918-333-4651
Practice Address - Street 1:2350 SE WASHINGTON BLVD STE 228
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-7211
Practice Address - Country:US
Practice Address - Phone:918-333-2929
Practice Address - Fax:918-333-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0882430001Medicare NSC
OK0882430001Medicare PIN