Provider Demographics
NPI:1235248113
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
Authorized Official - Prefix:MR
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:605-336-8800
Mailing Address - Street 1:502 S FOSS AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3051
Mailing Address - Country:US
Mailing Address - Phone:605-336-8800
Mailing Address - Fax:605-336-0187
Practice Address - Street 1:1616 S SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4204
Practice Address - Country:US
Practice Address - Phone:605-336-8800
Practice Address - Fax:605-336-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9281272Medicaid
SD9281272Medicaid