MEDICARE: MORROW 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	311Z00000X	Custodial Care Facility	3280T365	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	:	1356523484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORROW VISION CENTER, INC.

Provider Business Mailing Address
First Line	:	91 E MARION ST
Second Line	:
City	:	MT, GILEAD
State	:	OH
Zip	:	43338-1480
Country	:	US
Telephone Number	:	419-946-6881
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 E MARION ST
Second Line	:
City	:	MOUNT GILEAD
State	:	OH
Zip	:	43338-1434
Country	:	US
Telephone Number	:	419-946-6881
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	CHARLES E BOHMAN
Credential	:	O.D.
Telephone Number	:	419-946-6881

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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