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NPI Code Detail

MEDICARE: PROCARE VISION ENTER

MEDICARE: PROCARE VISION ENTER
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
1332H00000XEyewear Supplier3848OH

General Provider Information

NPI Number : 1013185271
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROCARE VISION ENTER
Provider Business Mailing Address
First Line : 1155 COLUMBUS PIKE
Second Line :
City : DELAWARE
State : OH
Zip : 43015-2713
Country : US
Telephone Number : 740-363-0787
Fax Number : 740-363-2927
Provider Business Practice Location Address
First Line : 1155 COLUMBUS PIKE
Second Line :
City : DELAWARE
State : OH
Zip : 43015-2713
Country : US
Telephone Number : 740-363-0787
Fax Number : 740-363-2927
Authorized Official
Title or Position : OFFICE MANAGER
Name : MISS D.D. OTT
Credential :
Telephone Number : 740-363-0787
Provider Enumeration Date : 02/11/2008
Last Update Date : 02/11/2008

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Directions to “PROCARE VISION ENTER ” Practice Location

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