MEDICARE: ROYAL OPTICS

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1700104270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL OPTICS

Provider Business Mailing Address
First Line	:	34393 PLYMOUTH RD
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48150-1539
Country	:	US
Telephone Number	:	734-522-6500
Fax Number	:	734-522-6510

Provider Business Practice Location Address
First Line	:	34393 PLYMOUTH RD
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48150-1539
Country	:	US
Telephone Number	:	734-522-6500
Fax Number	:	734-522-6510

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MASTON JOHN YEE
Credential	:
Telephone Number	:	734-522-6500

Provider Enumeration Date	:	05/08/2010
Last Update Date	:	05/08/2010

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Directions to “ROYAL OPTICS ” Practice Location

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