MEDICARE: COLE VISION CORPORATION

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	156FX1800X	Optician

General Provider Information

NPI Number	:	1366549396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLE VISION CORPORATION

Provider Business Mailing Address
First Line	:	13922 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-371-8330
Fax Number	:

Provider Business Practice Location Address
First Line	:	13922 CEDAR RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-371-8330
Fax Number	:

Authorized Official
Title or Position	:	MEDICARE SUPERVISOR
Name	:	MS. WENDY UHLS
Credential	:
Telephone Number	:	513-765-3534

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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Directions to “COLE VISION CORPORATION ” Practice Location

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