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General NPI Number Information
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NPI Number | 1427542315
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Entity Type | Organization
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Legal Business Name | 2020 VISION CARE LLC
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 4203 MURRAY AVE
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City | PITTSBURGH
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State | PA
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Zip | 15217-2975
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Country | US
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Telephone | 412-421-2020
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Fax | 412-422-2020
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Provider Business Mailing Address
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Address Line | 107 OLDE MANOR LN
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City | MOON TOWNSHIP
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State | PA
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Zip | 15108-9793
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Country | US
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Telephone | 412-608-8766
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Fax | 412-422-2020
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DR. MEGHAN MARIE SULLIVAN
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Credential | OD
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Telephone | 412-608-8766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003029
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License Number State | PA
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