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NPI 1023174018

NPI 1023174018 : PEARLE VISIONCARE, INC : SACRAMENTO, CA

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General NPI Number Information
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    NPI Number           |    1023174018
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    Entity Type          |    Organization 
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    Legal Business Name  |    PEARLE VISIONCARE, INC 
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Dates
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    Enumeration Date     |    12/28/2006
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    Last Update Date     |    03/06/2008
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Provider Practice Location Address
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    Address Line         |    1689 ARDEN WAY ARDEN FAIR MALL STE. 2100
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95815-4046
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    Country              |    US
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    Telephone            |    916-648-0209
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1689 ARDEN WAY ARDEN FAIR MALL STE. 2100
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    City                 |    SACRAMENTO
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    State                |    CA
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    Zip                  |    95815-4046
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    Country              |    US
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    Telephone            |    916-648-0209
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MEDICARE
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    Name                 |    MS. WENDY  UHLS 
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    Credential           |    
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    Telephone            |    513-765-3534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332H00000X
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    Taxonomy Name        |    Eyewear Supplier
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    License Number       |    
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    License Number State |    
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