Provider Demographics
NPI:1245785948
Name:WISCONSIN COUNCIL OF THE BLIND AND VISUALLY IMPAIRED, INC
Entity Type:Organization
Organization Name:WISCONSIN COUNCIL OF THE BLIND AND VISUALLY IMPAIRED, INC
Other - Org Name:SHARPER VISION STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-255-1166
Mailing Address - Street 1:754 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-3546
Mailing Address - Country:US
Mailing Address - Phone:608-255-1166
Mailing Address - Fax:608-255-3301
Practice Address - Street 1:754 WILLIAMSON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3546
Practice Address - Country:US
Practice Address - Phone:608-255-1166
Practice Address - Fax:608-255-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier