Provider Demographics
NPI:1073622924
Name:PRECISION VISION INC
Entity Type:Organization
Organization Name:PRECISION VISION INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEHR
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:605-361-9833
Mailing Address - Street 1:2414 S LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-4318
Mailing Address - Country:US
Mailing Address - Phone:605-361-9833
Mailing Address - Fax:605-361-0502
Practice Address - Street 1:1850 W EMPIRE MALL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-6522
Practice Address - Country:US
Practice Address - Phone:605-361-9833
Practice Address - Fax:605-361-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9281270Medicaid
SD0701500001Medicare UPIN