MEDICARE: FIELD OCULAR PROTHETICS LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	1000300-424	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346264751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIELD OCULAR PROTHETICS LLC

Provider Business Mailing Address
First Line	:	3752 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4921
Country	:	US
Telephone Number	:	702-451-3006
Fax Number	:	702-454-3937

Provider Business Practice Location Address
First Line	:	3752 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4921
Country	:	US
Telephone Number	:	702-451-3006
Fax Number	:	702-454-3937

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. JOAN E FIELD
Credential	:
Telephone Number	:	702-451-3006

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	12/06/2013

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