Provider Demographics
NPI:1447432091
Name:SUCCESS VISION EXPRESS
Entity Type:Organization
Organization Name:SUCCESS VISION EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-794-9029
Mailing Address - Street 1:7472 E ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-7913
Mailing Address - Country:US
Mailing Address - Phone:918-794-9029
Mailing Address - Fax:918-836-5171
Practice Address - Street 1:2129 SW WANAMAKER RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-5213
Practice Address - Country:US
Practice Address - Phone:785-272-6009
Practice Address - Fax:785-272-6871
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUCCESS VISION EXPRESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies