Provider Demographics
NPI:1144379330
Name:COLE VISION CORPORATION
Entity Type:Organization
Organization Name:COLE VISION CORPORATION
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 1:1219 S BOONE ST
Mailing Address - Street 2:SOUTH SHORE MALL
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-6738
Mailing Address - Country:US
Mailing Address - Phone:360-533-5066
Mailing Address - Fax:360-533-5066
Practice Address - Street 1:1219 S BOONE ST
Practice Address - Street 2:SOUTH SHORE MALL
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-6738
Practice Address - Country:US
Practice Address - Phone:360-533-5066
Practice Address - Fax:360-533-5066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0507950892Medicare ID - Type Unspecified