MEDICARE: CASSEYS OPTICAL, 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	332B00000X	Durable Medical Equipment & Medical Supplies		PA

General Provider Information

NPI Number	:	1821035759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASSEYS OPTICAL, INC

Provider Business Mailing Address
First Line	:	4590 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-1728
Country	:	US
Telephone Number	:	610-872-2643
Fax Number	:

Provider Business Practice Location Address
First Line	:	4590 EDGMONT AVE
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-1728
Country	:	US
Telephone Number	:	610-872-2643
Fax Number	:	610-872-2845

Authorized Official
Title or Position	:	OWNER
Name	:	SCOTT D CASSEY
Credential	:	ABO CERTIFIED
Telephone Number	:	610-872-2643

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	01/31/2014

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