MEDICARE: ELITE EYECARE INC.

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	152W00000X	Optometrist	OEG000031	PA

General Provider Information

NPI Number	:	1568606143
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE EYECARE INC.

Provider Business Mailing Address
First Line	:	320 MORGANTOWN RD
Second Line	:
City	:	READING
State	:	PA
Zip	:	19611-2059
Country	:	US
Telephone Number	:	610-898-0888
Fax Number	:	610-898-0891

Provider Business Practice Location Address
First Line	:	320 MORGANTOWN RD
Second Line	:
City	:	READING
State	:	PA
Zip	:	19611-2059
Country	:	US
Telephone Number	:	610-898-0888
Fax Number	:	610-898-0891

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SEAN HYMAN
Credential	:	O.D.
Telephone Number	:	610-898-0888

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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