Provider Demographics
NPI:1972715035
Name:EDMONDS, HUSZ & PEMBERTON EYE CENTER
Entity type:Organization
Organization Name:EDMONDS, HUSZ & PEMBERTON EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:520-795-3956
Mailing Address - Street 1:4730 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3521
Mailing Address - Country:US
Mailing Address - Phone:520-795-3956
Mailing Address - Fax:520-318-3431
Practice Address - Street 1:4730 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3521
Practice Address - Country:US
Practice Address - Phone:520-795-3956
Practice Address - Fax:520-318-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ27237Medicare ID - Type Unspecified