MEDICARE: ARLINGTON CONTACT LENS SERVICE, 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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1467760652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON CONTACT LENS SERVICE, INC

Provider Business Mailing Address
First Line	:	4265 DIPLOMACY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3834
Country	:	US
Telephone Number	:	614-921-9833
Fax Number	:	614-921-9866

Provider Business Practice Location Address
First Line	:	4265 DIPLOMACY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3834
Country	:	US
Telephone Number	:	614-921-9833
Fax Number	:	614-921-9866

Authorized Official
Title or Position	:	CEO
Name	:	DR. PETER CLARKSON
Credential	:	MD
Telephone Number	:	614-921-2552

Provider Enumeration Date	:	09/22/2010
Last Update Date	:	09/22/2010

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