Healthcare Provider Details

I. General information

NPI: 1649069691
Provider Name (Legal Business Name): JDS VISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 HUDSON DR
STOW OH
44224-2907
US

IV. Provider business mailing address

23105 FAIRMOUNT BLVD
SHAKER HEIGHTS OH
44122-2182
US

V. Phone/Fax

Practice location:
  • Phone: 330-923-8232
  • Fax:
Mailing address:
  • Phone: 570-575-2975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH SCHWARTZ
Title or Position: OWNER
Credential: OD
Phone: 570-575-2975