Provider Demographics
NPI:1477616175
Name:PEARLE VISION INC
Entity Type:Organization
Organization Name:PEARLE VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:UHLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-765-3534
Mailing Address - Street 1:1067 W BALTIMORE PIKE
Mailing Address - Street 2:GRANITE RUN MALL STE #269
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5121
Mailing Address - Country:US
Mailing Address - Phone:610-566-2047
Mailing Address - Fax:610-891-9271
Practice Address - Street 1:1067 W BALTIMORE PIKE
Practice Address - Street 2:GRANITE RUN MALL STE #269
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5121
Practice Address - Country:US
Practice Address - Phone:610-566-2047
Practice Address - Fax:610-891-9271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0132600176Medicare ID - Type Unspecified