MEDICARE: FOCUS EYE CARE 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	GA1174	GA

General Provider Information

NPI Number	:	1346465804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS EYE CARE INC.

Provider Business Mailing Address
First Line	:	804 LAKEMERE CRST
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-3468
Country	:	US
Telephone Number	:	770-886-8962
Fax Number	:	678-807-2694

Provider Business Practice Location Address
First Line	:	1570 OLD ALABAMA RD STE 106
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-2108
Country	:	US
Telephone Number	:	770-557-0039
Fax Number	:	678-623-3108

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	KIMBERLY E STOVALL
Credential	:
Telephone Number	:	678-697-8610

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	09/11/2019

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Directions to “FOCUS EYE CARE INC. ” Practice Location

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