Provider Demographics
NPI:1457487696
Name:VISION ASSOICATES INC
Entity Type:Organization
Organization Name:VISION ASSOICATES INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:KOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-328-8811
Mailing Address - Street 1:5600 S 59TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2386
Mailing Address - Country:US
Mailing Address - Phone:402-328-8811
Mailing Address - Fax:402-328-8813
Practice Address - Street 1:5600 S 59TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-2386
Practice Address - Country:US
Practice Address - Phone:402-328-8811
Practice Address - Fax:402-328-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
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 Answered332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========03Medicaid
NE09877Medicare ID - Type Unspecified