Healthcare Provider Details

I. General information

NPI: 1235288952
Provider Name (Legal Business Name): COLE VISION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3-2600 KAUMUALII HWY
LIHUE HI
96766-2040
US

IV. Provider business mailing address

3-2600 KAUMUALII HWY
LIHUE HI
96766-2040
US

V. Phone/Fax

Practice location:
  • Phone: 808-246-6789
  • Fax: 808-246-9641
Mailing address:
  • Phone: 808-246-6789
  • Fax: 808-246-9641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDY UHLS
Title or Position: MEDICARE SUPERVISOR
Credential:
Phone: 513-765-3534