Provider Demographics
NPI:1841341898
Name:VISUAL EDGE, INC
Entity type:Organization
Organization Name:VISUAL EDGE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:W 385 WEST MARKET
Mailing Address - Street 2:MALL OF AMERICA
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425
Mailing Address - Country:US
Mailing Address - Phone:952-854-4500
Mailing Address - Fax:952-858-8525
Practice Address - Street 1:W 385 WEST MARKET
Practice Address - Street 2:MALL OF AMERICA
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425
Practice Address - Country:US
Practice Address - Phone:952-854-4500
Practice Address - Fax:952-858-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
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
MN4B398PEOtherBCBS VISION EXAMS
MN0626900001OtherMEDICARE DMERC REGION B
MNPE1512536OtherCLARITY VISION
MN4B400PEOtherBCBS EYEWEAR
MN21-26597OtherMEDICA-UHC
MN21-26597OtherMEDICA-UHC