Healthcare Provider Details

I. General information

NPI: 1588092621
Provider Name (Legal Business Name): RENUVISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 MEDINA RD
MEDINA OH
44256-8181
US

IV. Provider business mailing address

3609 MEDINA RD
MEDINA OH
44256-8181
US

V. Phone/Fax

Practice location:
  • Phone: 330-722-1313
  • Fax: 330-723-3003
Mailing address:
  • Phone: 330-722-1313
  • Fax: 330-723-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4976
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35048832
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35092551
License Number StateOH

VIII. Authorized Official

Name: ANDREW A ESPOSITO
Title or Position: OWNER / OPHTHALMOLOGIST
Credential: M.D.
Phone: 330-722-1313