MEDICARE: UNIVERSAL CONTACT LENSES, 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	152W00000X	Optometrist	OEG000083	PA

General Provider Information

NPI Number	:	1194779280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSAL CONTACT LENSES, INC.

Provider Business Mailing Address
First Line	:	6155 RIDGE AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19128-2627
Country	:	US
Telephone Number	:	215-483-3400
Fax Number	:	215-483-7401

Provider Business Practice Location Address
First Line	:	6155 RIDGE AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19128-2627
Country	:	US
Telephone Number	:	215-483-3400
Fax Number	:	215-483-7401

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. BERNICE KESSLER
Credential	:
Telephone Number	:	215-483-3400

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	04/30/2008

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