Provider Demographics
NPI:1750569174
Name:VISION PLUS INC
Entity type:Organization
Organization Name:VISION PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMERINE HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:479-452-8200
Mailing Address - Street 1:4900 ROGERS AVE STE 103A
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-2068
Mailing Address - Country:US
Mailing Address - Phone:479-452-8200
Mailing Address - Fax:
Practice Address - Street 1:4900 ROGERS AVE STE 103A
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-2068
Practice Address - Country:US
Practice Address - Phone:479-452-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2339332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0334050001Medicare NSC