Provider Demographics
NPI:1245383306
Name:GREENLEE & REID, INC
Entity Type:Organization
Organization Name:GREENLEE & REID, INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:H
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-326-9146
Mailing Address - Street 1:4601 E MAIN ST
Mailing Address - Street 2:STE. 120
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-8667
Mailing Address - Country:US
Mailing Address - Phone:505-326-9146
Mailing Address - Fax:505-325-0365
Practice Address - Street 1:4601 E MAIN ST
Practice Address - Street 2:STE. 120
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-8667
Practice Address - Country:US
Practice Address - Phone:505-326-9146
Practice Address - Fax:505-325-0365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM0415300001Medicare NSC