Provider Demographics
NPI:1982150835
Name:DOLLARVISIONCLUB CORP.
Entity Type:Organization
Organization Name:DOLLARVISIONCLUB CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:219-655-9398
Mailing Address - Street 1:9445 INDIANAPOLIS BLVD # 199
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2648
Mailing Address - Country:US
Mailing Address - Phone:219-655-9398
Mailing Address - Fax:
Practice Address - Street 1:9445 INDIANAPOLIS BLVD # 199
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2648
Practice Address - Country:US
Practice Address - Phone:219-655-9398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156F00000XEye and Vision Services ProvidersTechnician/TechnologistGroup - Multi-Specialty
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact LensGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty