Basic Information
| Provider Information | |||||||||
| NPI: | 1427525625 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SVS VISION INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 CASS AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNT CLEMENS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480432204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864641479 | ||||||||
| FaxNumber: | 5864641480 | ||||||||
| Practice Location | |||||||||
| Address1: | 12371 JAMES ST STE 20 | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494247618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6162948280 | ||||||||
| FaxNumber: | 6162944866 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2018 | ||||||||
| LastUpdateDate: | 01/08/2019 | ||||||||
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| AuthorizedOfficialLastName: | FRESHNEY | ||||||||
| AuthorizedOfficialFirstName: | JILL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROFESSIONAL SERVICES MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5864641479 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | N | Suppliers | Eyewear Supplier (Equipment, not the service) | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.