Healthcare Provider Details

I. General information

NPI: 1366549396
Provider Name (Legal Business Name): COLE VISION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13922 CEDAR RD
UNIVERSITY HEIGHTS OH
44118-3204
US

IV. Provider business mailing address

13922 CEDAR RD
UNIVERSITY HEIGHTS OH
44118-3204
US

V. Phone/Fax

Practice location:
  • Phone: 216-371-8330
  • Fax:
Mailing address:
  • Phone: 216-371-8330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

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