MEDICARE: HANDSCHUMACHER ENTERPRISES OD PA

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	1708	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912955337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDSCHUMACHER ENTERPRISES OD PA

Provider Business Mailing Address
First Line	:	7500 RAMBLE WAY
Second Line	:	SUITE 101
City	:	RALEIGH
State	:	NC
Zip	:	27616-4307
Country	:	US
Telephone Number	:	919-981-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 RAMBLE WAY
Second Line	:	SUITE 101
City	:	RALEIGH
State	:	NC
Zip	:	27616-4307
Country	:	US
Telephone Number	:	919-981-4444
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY HANDSCHUMACHER
Credential	:	O.D.
Telephone Number	:	252-985-3937

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/20/2024

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