Provider Demographics
NPI:1154744712
Name:FAMILY VISION CENTER
Entity type:Organization
Organization Name:FAMILY VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEKITES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:907-569-2020
Mailing Address - Street 1:PO BOX 214402
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-4402
Mailing Address - Country:US
Mailing Address - Phone:907-569-2020
Mailing Address - Fax:
Practice Address - Street 1:3101 A ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-4008
Practice Address - Country:US
Practice Address - Phone:907-569-2020
Practice Address - Fax:907-222-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK152305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization