Provider Demographics
NPI:1346392438
Name:LUERSSEN INC
Entity Type:Organization
Organization Name:LUERSSEN INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LUERSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-758-1292
Mailing Address - Street 1:2720 S COLORADO BLVD
Mailing Address - Street 2:704
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6627
Mailing Address - Country:US
Mailing Address - Phone:303-758-1292
Mailing Address - Fax:303-758-0167
Practice Address - Street 1:2720 S COLORADO BLVD
Practice Address - Street 2:704
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6627
Practice Address - Country:US
Practice Address - Phone:303-758-1292
Practice Address - Fax:303-758-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21538790000332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier