Provider Demographics
NPI:1043542921
Name:KLEAR VISION INCORPORATED
Entity Type:Organization
Organization Name:KLEAR VISION INCORPORATED
Other - Org Name:BRIGHTSTAR OF CABARRUS/STANLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEDRICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-721-7827
Mailing Address - Street 1:35 CHURCH ST S
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-3511
Mailing Address - Country:US
Mailing Address - Phone:704-721-7827
Mailing Address - Fax:704-720-7827
Practice Address - Street 1:35 CHURCH ST S
Practice Address - Street 2:SUITE 104
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-3511
Practice Address - Country:US
Practice Address - Phone:704-721-7827
Practice Address - Fax:704-720-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4099251E00000X
NCNP4041251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care