MEDICARE: CUNNINGHAM OPTICAL CO INC

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1212670002	OTHER	IN	MEDICARE NSC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184610933
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUNNINGHAM OPTICAL CO INC

Provider Business Mailing Address
First Line	:	5535 S SCATTERFIELD RD
Second Line	:
City	:	ANDERSON
State	:	IN
Zip	:	46013-3140
Country	:	US
Telephone Number	:	765-644-7222
Fax Number	:	765-642-7608

Provider Business Practice Location Address
First Line	:	5535 S SCATTERFIELD RD
Second Line	:
City	:	ANDERSON
State	:	IN
Zip	:	46013-3140
Country	:	US
Telephone Number	:	765-644-7222
Fax Number	:	765-642-7608

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MRS. PAULA K BRADLEY
Credential	:
Telephone Number	:	765-644-7222

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	04/26/2013

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Directions to “CUNNINGHAM OPTICAL CO INC ” Practice Location

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