Provider Demographics
NPI:1891821039
Name:VISION ASSOCIATES INC
Entity Type:Organization
Organization Name:VISION ASSOCIATES INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:KOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-382-9205
Mailing Address - Street 1:1437 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-2313
Mailing Address - Country:US
Mailing Address - Phone:308-382-9205
Mailing Address - Fax:308-382-3414
Practice Address - Street 1:1437 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-2313
Practice Address - Country:US
Practice Address - Phone:308-382-9205
Practice Address - Fax:308-382-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========02Medicaid
NE094146Medicare ID - Type Unspecified