MEDICARE: GLOBAL VISION SOURCES 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	302F00000X	Exclusive Provider Organization	1978	AZ

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	:	1306378849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL VISION SOURCES INC.

Provider Business Mailing Address
First Line	:	7500 E DEER VALLEY RD
Second Line	:	UNIT 155
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-4814
Country	:	US
Telephone Number	:	301-356-2656
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 E DEER VALLEY RD
Second Line	:	UNIT 155
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-4814
Country	:	US
Telephone Number	:	301-356-2656
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	OLAKUNLE SOWUNMI
Credential	:
Telephone Number	:	202-341-1240

Provider Enumeration Date	:	04/03/2017
Last Update Date	:	04/03/2017

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Directions to “GLOBAL VISION SOURCES INC. ” Practice Location

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