Healthcare Provider Details

I. General information

NPI: 1942345921
Provider Name (Legal Business Name): SVS VISION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E GRAND RIVER AVE
BRIGHTON MI
48116-1551
US

IV. Provider business mailing address

118 CASS AVE
MOUNT CLEMENS MI
48043-2204
US

V. Phone/Fax

Practice location:
  • Phone: 810-227-2376
  • Fax: 810-227-4390
Mailing address:
  • Phone: 586-468-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT G FARRELL JR.
Title or Position: OWNER/CEO
Credential: OD
Phone: 586-468-7370