Alvernon Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

813 Issued in AZ

Legal business name

ALVERNON OPTICAL, INC.

Practice address

7123 E Tanque Verde Rd
Tucson, AZ 85715-3431

Phone

(520) 296-4157

Fax

(520) 296-4418

NPI assigned

Mar 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacia A Decker, LDO

Title

VP of Retail

Phone

(520) 327-6215

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629195029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7123 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153431",
            "telephone_number": "520-296-4157",
            "fax_number": "520-296-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 E TANQUE VERDE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857153431",
            "telephone_number": "520-296-4157",
            "fax_number": "520-296-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVERNON OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "STACIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP OF RETAIL",
        "authorized_official_telephone_number": "520-327-6215",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "AZ",
            "license": "813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413906",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Luisa Minerva Alviso
• Ruwani Alwis, MBBS

• Eyewear Supplier in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Eyewear Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.