MEDICARE: STEVENS OPTICAL

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	156FX1800X	Optician	SC4580	OH

General Provider Information

NPI Number	:	1043331754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVENS OPTICAL

Provider Business Mailing Address
First Line	:	130 N MARKET ST
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-2019
Country	:	US
Telephone Number	:	330-426-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 N MARKET ST
Second Line	:
City	:	EAST PALESTINE
State	:	OH
Zip	:	44413-2019
Country	:	US
Telephone Number	:	330-426-7777
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	MR. STEVEN EPPSTEIN
Credential	:
Telephone Number	:	333-426-7777

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/22/2020

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Directions to “STEVENS OPTICAL ” Practice Location

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