Provider Demographics
NPI:1922266527
Name:PEARLE VISION
Entity Type:Organization
Organization Name:PEARLE VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STORE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-786-0300
Mailing Address - Street 1:95 N MOORLAND RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-6020
Mailing Address - Country:US
Mailing Address - Phone:262-786-0300
Mailing Address - Fax:262-786-1239
Practice Address - Street 1:95 N MOORLAND RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-6020
Practice Address - Country:US
Practice Address - Phone:262-786-0300
Practice Address - Fax:262-786-1239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty