Provider Demographics
NPI:1477183952
Name:INVISION OPTICAL, LLC
Entity Type:Organization
Organization Name:INVISION OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:
Authorized Official - Last Name:COUSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-445-3154
Mailing Address - Street 1:PO BOX 2231
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459-2231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2078 WOODMERE BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2245
Practice Address - Country:US
Practice Address - Phone:985-445-3154
Practice Address - Fax:985-641-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier