Provider Demographics
NPI:1114083102
Name:PEARLE VISIONCARE, INC
Entity Type:Organization
Organization Name:PEARLE VISIONCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:UHLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-765-3534
Mailing Address - Street 1:72 393 HWY 111
Mailing Address - Street 2:DESERT CROSSING SHOPPING CENTER STE.A
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260
Mailing Address - Country:US
Mailing Address - Phone:760-862-0033
Mailing Address - Fax:760-340-4407
Practice Address - Street 1:72 393 HWY111
Practice Address - Street 2:DESERT CROSSING SHOPPING CENTER STE.A
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260
Practice Address - Country:US
Practice Address - Phone:760-862-0033
Practice Address - Fax:760-340-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0132600421Medicare ID - Type Unspecified