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NPI Code Detail

MEDICARE: OHIO STATE OPTICAL CO

MEDICARE: OHIO STATE OPTICAL CO
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
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1922166180
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO STATE OPTICAL CO
Provider Business Mailing Address
First Line : 1325 CAMERON AVE
Second Line :
City : LEWIS CENTER
State : OH
Zip : 43035-9662
Country : US
Telephone Number : 614-888-3972
Fax Number : 614-888-3709
Provider Business Practice Location Address
First Line : 50 MCNAUGHTEN RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2120
Country : US
Telephone Number : 614-866-4843
Fax Number : 614-866-8526
Authorized Official
Title or Position : PRESIDENT
Name : MR. R. EMIL HAGMAN
Credential :
Telephone Number : 614-888-3972
Provider Enumeration Date : 12/04/2006
Last Update Date : 08/22/2020

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Directions to “OHIO STATE OPTICAL CO ” Practice Location

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