Organization
REAL EYES LLC
Active
Other names
PEARLE VISION
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY BURRAGE (CEO)
(952) 933-3722
Entity
Organization
Contact information
Practice address
8332 HIGHWAY 7, KNOLLWOOD MALL, ST LOUIS PARK, MN 55426-3991
(952) 933-3722
(952) 933-6578
Mailing address
8332 HIGHWAY 7, KNOLLWOOD MALL, ST LOUIS PARK, MN 55426-3991
(952) 933-3722
(952) 933-6578
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0626900006
MEDICARE DMERC REGION B
MN
01
—
20B03PE
BCBS STORE
MN
01
—
21-28989
MEDICA-UHC
MN
01
—
21B67PE
BCBS DR
MN
05
—
669479900
—
MN
01
—
C05046
MEDICARE PART B WPS
MN
Enumeration date
01/17/2007
Last updated
12/08/2008
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