MEDICARE: EAGLE EYES, LLC

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

General Provider Information

NPI Number	:	1932381241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE EYES, LLC

Provider Business Mailing Address
First Line	:	1001 E ENTRY DR
Second Line	:	SUITE 333
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2943
Country	:	US
Telephone Number	:	412-344-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	4057 WASHINGTON RD
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-2520
Country	:	US
Telephone Number	:	724-941-2620
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NORMAN CHILDS
Credential	:
Telephone Number	:	412-344-1300

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/28/2007

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