MEDICARE: DR. BARTON B. RACK O.D.

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	152WC0802X	Corneal and Contact Management Optometrist	OE005035T	PA

General Provider Information

NPI Number	:	1164472429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARTON B. RACK O.D.

Provider Business Mailing Address
First Line	:	9 LINSHAW AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-2029
Country	:	US
Telephone Number	:	412-921-5470
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 LINSHAW AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-2029
Country	:	US
Telephone Number	:	412-921-5470
Fax Number	:	412-921-5580

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	05/20/2011

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