Provider Demographics
NPI:1902057920
Name:SIAD INC A NC CORPORATION
Entity Type:Organization
Organization Name:SIAD INC A NC CORPORATION
Other - Org Name:BILTMORE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-665-0603
Mailing Address - Street 1:17 SARDIS RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-8536
Mailing Address - Country:US
Mailing Address - Phone:828-665-0603
Mailing Address - Fax:
Practice Address - Street 1:17 SARDIS RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-8536
Practice Address - Country:US
Practice Address - Phone:828-665-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC40483OtherDAVIS VISION
NC8802013Medicaid
NC0177MOtherNC HEALTH CHOICE