MEDICARE: EYEWEAR INTERNATIONAL/TV OPTICIANS

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	5656	OH

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	:	1326271206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEWEAR INTERNATIONAL/TV OPTICIANS

Provider Business Mailing Address
First Line	:	23611 CHAGRIN BLVD STE 120
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:	216-896-0316
Fax Number	:	216-896-9997

Provider Business Practice Location Address
First Line	:	23611 CHAGRIN BLVD STE 120
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:	216-896-0316
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TONYA VAUGHN
Credential	:
Telephone Number	:	216-896-0316

Provider Enumeration Date	:	08/26/2009
Last Update Date	:	03/07/2024

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Directions to “EYEWEAR INTERNATIONAL/TV OPTICIANS ” Practice Location

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