MEDICARE: BARRETT VISION CENTER 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

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

General Provider Information

NPI Number	:	1235397480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRETT VISION CENTER INC

Provider Business Mailing Address
First Line	:	515 26TH ST
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2026
Country	:	US
Telephone Number	:	814-943-4710
Fax Number	:	814-943-3721

Provider Business Practice Location Address
First Line	:	515 26TH ST
Second Line	:
City	:	ALTOONA
State	:	PA
Zip	:	16602-2026
Country	:	US
Telephone Number	:	814-943-4710
Fax Number	:	814-943-3721

Authorized Official
Title or Position	:	INSURANCE COORDINATOR
Name	:	MR. CHADNEY DIEHL
Credential	:
Telephone Number	:	814-943-4710

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	09/02/2016

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