Organization
BEACH EYE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIVEK JAIN MD (PRESIDENT)
(757) 425-5550
Entity
Organization
Contact information
Practice address
1201 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2217
(757) 425-5550
(757) 412-2606
Mailing address
1201 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-2217
(757) 425-5550
(757) 412-2606
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010147859
—
VA
01
—
0618002731
STATE LICENSE
VA
01
—
89015YK
NC MEDICAID
—
01
—
CL3147
MEDICARE RAILROAD
VA
Enumeration date
09/16/2005
Last updated
01/27/2025
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