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Contact Information

CRESTWOOD OPTICAL
8078 SUDLEY RD
MANASSAS, VA20109
 Phone: 703-369-1616
 Fax: 703-369-7902
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optician

156FX1800X 96[5] Optician
Indicates primary specialty

NPI Profile & details for CRESTWOOD OPTICAL

NPI # 1275550089
LBN Legal business name CRESTWOOD OPTICAL
Authorized official ERIC KELLER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/16/2006
Last updated 06/20/2008 - About 18 years ago
Identifiers
VA License # 967
VA Medicaid 9282831
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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