MEDICARE: NEVADA OPTICAL AND PUBLISHING ENTERPRISES FOR PROFESSIONAL LLC

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	156FX1800X	Optician	296	NV

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	:	1497824593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA OPTICAL AND PUBLISHING ENTERPRISES FOR PROFESSIONAL LLC

Provider Business Mailing Address
First Line	:	2400 W CHARLESTON BLVD STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2152
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 W CHARLESTON BLVD STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2152
Country	:	US
Telephone Number	:	702-870-5911
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. BETTY WILLIAMS
Credential	:
Telephone Number	:	702-870-5911

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	12/04/2008

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