Provider Demographics
NPI:1659472777
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 1:8145 W SAHARA AVE
Mailing Address - Street 2:STE 510
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1994
Mailing Address - Country:US
Mailing Address - Phone:702-869-1744
Mailing Address - Fax:
Practice Address - Street 1:8145 W SAHARA AVE
Practice Address - Street 2:STE 510
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1994
Practice Address - Country:US
Practice Address - Phone:702-869-1744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0132600492Medicare ID - Type Unspecified