Provider Demographics
NPI:1427498344
Name:CLEARVIEW EYE CARE, INC
Entity type:Organization
Organization Name:CLEARVIEW EYE CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-275-9090
Mailing Address - Street 1:1932 KEMPSVILLE RD
Mailing Address - Street 2:#106
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-6953
Mailing Address - Country:US
Mailing Address - Phone:757-275-9090
Mailing Address - Fax:757-275-9092
Practice Address - Street 1:1932 KEMPSVILLE RD
Practice Address - Street 2:#106
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-6953
Practice Address - Country:US
Practice Address - Phone:757-275-9090
Practice Address - Fax:757-275-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001498152W00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC765Medicare PIN