Provider Demographics
NPI:1386993863
Name:RITE-EYES, INC.
Entity type:Organization
Organization Name:RITE-EYES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-938-9170
Mailing Address - Street 1:3983 LAVISTA ROAD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084
Mailing Address - Country:US
Mailing Address - Phone:770-938-9170
Mailing Address - Fax:770-270-9025
Practice Address - Street 1:3983 LAVISTA ROAD
Practice Address - Street 2:SUITE 125
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084
Practice Address - Country:US
Practice Address - Phone:770-938-9170
Practice Address - Fax:770-270-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA1104152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA348726036BMedicaid
GA348726036BMedicaid