Provider Demographics
NPI:1942077243
Name:VISION CENTERS OF ALASKA, INC
Entity Type:Organization
Organization Name:VISION CENTERS OF ALASKA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPTOMETRIC SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDIGO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-987-1850
Mailing Address - Street 1:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45167-0053
Mailing Address - Country:US
Mailing Address - Phone:513-987-1850
Mailing Address - Fax:
Practice Address - Street 1:104 CHENEGA AVE, STE 1368
Practice Address - Street 2:
Practice Address - City:VALDEZ
Practice Address - State:AK
Practice Address - Zip Code:99686-1368
Practice Address - Country:US
Practice Address - Phone:907-444-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty