MEDICARE: LOW VISION SERVICES, P.C.

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	152WL0500X	Low Vision Rehabilitation Optometrist	18002014A	IN

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
2	870012372	OTHER	IN	PALMETTO GBA

General Provider Information

NPI Number	:	1538216171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOW VISION SERVICES, P.C.

Provider Business Mailing Address
First Line	:	200 W 103RD ST STE 2030
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1092
Country	:	US
Telephone Number	:	317-817-1772
Fax Number	:	317-805-4520

Provider Business Practice Location Address
First Line	:	200 W 103RD ST STE 2030
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1092
Country	:	US
Telephone Number	:	317-817-1772
Fax Number	:	317-805-4520

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL P. BITHER
Credential	:	O.D.
Telephone Number	:	317-817-1772

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	02/04/2010

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