Healthcare Provider Details

I. General information

NPI: 1821347907
Provider Name (Legal Business Name): PUREVUE VISION CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6035 PEACHTREE PKWY STE A
NORCROSS GA
30092-3369
US

IV. Provider business mailing address

6035 PEACHTREE PKWY STE A
PEACHTREE CORNERS GA
30092-3369
US

V. Phone/Fax

Practice location:
  • Phone: 770-903-4555
  • Fax: 770-903-4556
Mailing address:
  • Phone: 770-903-4555
  • Fax: 770-903-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT002172
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NHAT ANH THI HO
Title or Position: PRESIDENT
Credential: OD
Phone: 770-903-4555