MEDICARE: AMERICAN OPTICAL AND CONTACT LENSES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	0101052346	VA

General Provider Information

NPI Number	:	1144661109
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN OPTICAL AND CONTACT LENSES

Provider Business Mailing Address
First Line	:	3400 PAYNE ST STE 200
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2313
Country	:	US
Telephone Number	:	703-820-0804
Fax Number	:

Provider Business Practice Location Address
First Line	:	8650 GEORGIA AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-3404
Country	:	US
Telephone Number	:	301-589-7474
Fax Number	:	301-589-7159

Authorized Official
Title or Position	:	OWNER
Name	:	HAMEED PERACHA
Credential	:	MD
Telephone Number	:	703-820-0804

Provider Enumeration Date	:	07/07/2013
Last Update Date	:	09/09/2016

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