Organization
ALVERNON OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIA A DECKER LDO (VP OF RETAIL)
(520) 327-6215
Entity
Organization
Contact information
Practice address
4747 E SUNRISE DR, TUCSON, AZ 85718-8500
(520) 299-4000
(520) 577-7656
Mailing address
4747 E SUNRISE DR, TUCSON, AZ 85718-8500
(520) 299-4000
(520) 577-7656
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405200
—
AZ
Enumeration date
03/23/2007
Last updated
10/30/2008
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