MEDICARE: LENTZ EYE CARE 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	332H00000X	Eyewear Supplier	18002887B	IN

General Provider Information

NPI Number	:	1861691222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LENTZ EYE CARE INC

Provider Business Mailing Address
First Line	:	10043 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2623
Country	:	US
Telephone Number	:	317-897-9819
Fax Number	:	317-899-1654

Provider Business Practice Location Address
First Line	:	10043 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2623
Country	:	US
Telephone Number	:	317-897-9819
Fax Number	:	317-899-1654

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM KARL LENTZ
Credential	:	O.D.
Telephone Number	:	317-897-9819

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	07/16/2007

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