Provider Demographics
NPI:1356498075
Name:OCULARRA HOLDING. INC
Entity Type:Organization
Organization Name:OCULARRA HOLDING. 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:MERLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:763-784-4081
Mailing Address - Street 1:15780 SKYLINE AVE NW
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372-1629
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:570 NORTHTOWN DR NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-1043
Practice Address - Country:US
Practice Address - Phone:763-784-4081
Practice Address - Fax:763-784-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2120247OtherMEDICA
MN65167PEOtherBLUE CROSS BLE SHEILD
MN65302PEOtherBLUE CROSS BLUE SHEILD
MN103232OtherUCARE
MN31854OtherHEALTH PARTNERS
MN65167PEOtherBLUE CROSS BLE SHEILD