Organization
ALVERNON OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACIA A DECKER LICENSED OPTICIAN (VICE PRESIDENT OF RETAIL)
(520) 327-6215
Entity
Organization
Contact information
Practice address
440 N ALVERNON WAY, SUITE 101, TUCSON, AZ 85711-1958
(520) 327-6215
(520) 327-6546
Mailing address
440 N ALVERNON WAY, SUITE 101, TUCSON, AZ 85711-1958
(520) 327-6215
(520) 327-6546
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
813
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155475
—
AZ
Enumeration date
08/31/2006
Last updated
08/22/2020
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