MEDICARE: EDWARD ROSS, OD

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	OEG1576	PA

General Provider Information

NPI Number	:	1912176843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWARD ROSS, OD

Provider Business Mailing Address
First Line	:	1821 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1605
Country	:	US
Telephone Number	:	412-521-6622
Fax Number	:

Provider Business Practice Location Address
First Line	:	1821 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1605
Country	:	US
Telephone Number	:	412-521-6622
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. EDWARD ROSS
Credential	:	OD
Telephone Number	:	412-521-6622

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/25/2008

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