Provider Demographics
NPI:1770666844
Name:ALLIED VISION INC
Entity Type:Organization
Organization Name:ALLIED VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-626-2029
Mailing Address - Street 1:PO BOX 2555
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-0555
Mailing Address - Country:US
Mailing Address - Phone:330-626-2029
Mailing Address - Fax:330-626-5955
Practice Address - Street 1:9088 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-5699
Practice Address - Country:US
Practice Address - Phone:330-626-2029
Practice Address - Fax:330-626-5955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH888332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0092653Medicaid
OH000000155595OtherAETNA
OH=========001OtherMEDICAL MUTIAL
OH0697500001Medicare NSC