Provider Demographics
NPI:1487214763
Name:PURVISION LLC
Entity Type:Organization
Organization Name:PURVISION LLC
Other - Org Name:20/20 EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-792-2020
Mailing Address - Street 1:2464 W MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-6413
Mailing Address - Country:US
Mailing Address - Phone:334-792-2020
Mailing Address - Fax:
Practice Address - Street 1:2464 W MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-6413
Practice Address - Country:US
Practice Address - Phone:334-792-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty