Healthcare Provider Details

I. General information

NPI: 1679123590
Provider Name (Legal Business Name): ACUITY VISION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11114 S LONE ELM RD
OLATHE KS
66061-9434
US

IV. Provider business mailing address

211 E BROADWAY
ALTON IL
62002-6220
US

V. Phone/Fax

Practice location:
  • Phone: 913-390-6700
  • Fax: 913-390-6705
Mailing address:
  • Phone: 618-462-9818
  • Fax: 314-741-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JOHN E PITTS
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 972-370-5552