1447420534 NPI number — VISIONS OPTIQUE, INC

Table of content: (NPI 1447420534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447420534 NPI number — VISIONS OPTIQUE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VISIONS OPTIQUE, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VISIONS OPTIQUE & EYECARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447420534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18291 N PIMA RD
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85255-5697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-515-2727
Provider Business Mailing Address Fax Number:
480-515-2747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18291 N PIMA RD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85255-5697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-515-2727
Provider Business Practice Location Address Fax Number:
480-515-2747
Provider Enumeration Date:
03/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
UELNER
Authorized Official First Name:
TIFFANY
Authorized Official Middle Name:
CLEPPER
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
480-515-2727

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  1375 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152WV0400X , with the licence number: 1375R , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1447420534 . This is a "NPI" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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