MEDICARE: RICHMOND EYE CARE, PLLC

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	0618001166	VA

General Provider Information

NPI Number	:	1609387802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMOND EYE CARE, PLLC

Provider Business Mailing Address
First Line	:	1770 N PARHAM RD STE 101
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-366-5871
Fax Number	:

Provider Business Practice Location Address
First Line	:	1770 N PARHAM RD STE 101
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23229-4658
Country	:	US
Telephone Number	:	804-366-5871
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOSHUA FOREST SHOWS
Credential	:	OD
Telephone Number	:	804-366-5871

Provider Enumeration Date	:	10/16/2017
Last Update Date	:	10/16/2017

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