MEDICARE: PERRY EPSTEIN CORP.

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	26 SC	OH

General Provider Information

NPI Number	:	1134398068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRY EPSTEIN CORP.

Provider Business Mailing Address
First Line	:	34050 SOLON RD
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-2664
Country	:	US
Telephone Number	:	440-248-8535
Fax Number	:

Provider Business Practice Location Address
First Line	:	34050 SOLON RD
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-2664
Country	:	US
Telephone Number	:	440-248-8535
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PERRY EPSTEIN
Credential	:	LICENSED OPTICIAN
Telephone Number	:	440-248-8535

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/25/2008

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Directions to “PERRY EPSTEIN CORP. ” Practice Location

Language	Start Address	Practice Location

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