Provider Demographics
NPI:1275699191
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 1:5599 CENTRAL AVE
Mailing Address - Street 2:EASTLAND MALL
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2707
Mailing Address - Country:US
Mailing Address - Phone:704-531-4330
Mailing Address - Fax:704-531-9889
Practice Address - Street 1:5599 CENTRAL AVE
Practice Address - Street 2:EASTLAND MALL
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-2707
Practice Address - Country:US
Practice Address - Phone:704-531-4330
Practice Address - Fax:704-531-9889
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
NC0507950124Medicare ID - Type Unspecified