Provider Demographics
NPI:1457357071
Name:VISUAL EDGE, INC
Entity Type:Organization
Organization Name:VISUAL EDGE, INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZWEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-345-5044
Mailing Address - Street 1:3333 HAZELTON RD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4204
Mailing Address - Country:US
Mailing Address - Phone:952-926-5300
Mailing Address - Fax:952-915-9212
Practice Address - Street 1:3333 HAZELTON RD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4204
Practice Address - Country:US
Practice Address - Phone:952-926-6149
Practice Address - Fax:952-926-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1068294156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN102075OtherCOLE MANAGED VISION
MN21-20194OtherMEDICA/UNITED HEALTHCARE
MN0626900005OtherMEDICARE DMERC REGION B
MN65160PEOtherBCBS VISION EXAMS
MNPE1512548OtherCLARITY VISION
MN65161PEOtherBCBS EYEWEAR
MN0626900005OtherMEDICARE DMERC REGION B