Provider Demographics
NPI:1033423751
Name:VALUE VISION EXPRESS
Entity Type:Organization
Organization Name:VALUE VISION EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-457-3123
Mailing Address - Street 1:8421 UNIVERSITY BLVD STE H2
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1036
Mailing Address - Country:US
Mailing Address - Phone:515-457-3123
Mailing Address - Fax:
Practice Address - Street 1:8421 UNIVERSITY BLVD STE H2
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1036
Practice Address - Country:US
Practice Address - Phone:515-457-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier