Provider Demographics
NPI:1205981636
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:
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 1:21500 NORTHWESTERN HWY
Mailing Address - Street 2:SP D17C
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5018
Mailing Address - Country:US
Mailing Address - Phone:248-559-3737
Mailing Address - Fax:248-559-8211
Practice Address - Street 1:21500 NORTHWESTERN HWY
Practice Address - Street 2:SP D17C
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5018
Practice Address - Country:US
Practice Address - Phone:248-559-3737
Practice Address - Fax:248-559-8211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty