| Pearle Vision Express | |
|
1518 E Battlefield St Springfield MO 65804-3704 | |
| (417) 881-5530 | |
| (417) 889-4071 |
| Full Name | Pearle Vision Express |
|---|---|
| Speciality | Clinic/Center |
| Location | 1518 E Battlefield St, Springfield, Missouri |
| Authorized Official Name and Position | Laura Leann Cross (OPERATIONS MANAGER) |
| Authorized Official Contact | 4178815530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pearle Vision Express 1518 E Battlefield St Springfield MO 65804-3704 Ph: (417) 881-5530 | Pearle Vision Express 1518 E Battlefield St Springfield MO 65804-3704 Ph: (417) 881-5530 |
| NPI Number | 1528273927 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 05/13/2021 |
| Certification Date | 05/13/2021 |
| Medicare PECOS PAC ID | 9931356045 |
|---|---|
| Medicare Enrollment ID | O20120824000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528273927 | NPI | - | NPPES |
| 320042807 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 156FX1800X | Technician/technologist - Optician | 17822 (California) | Secondary |
| Provider Name | Eric D Gericke |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598884884 PECOS PAC ID: 5799952271 Enrollment ID: I20120124000847 |
| Provider Name | Benjamin Tatsunori Iwai |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417399890 PECOS PAC ID: 8527294479 Enrollment ID: I20210324001093 |
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