MEDICARE: WARBY PARKER 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	:	1568011377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARBY PARKER INC.

Provider Business Mailing Address
First Line	:	233 SPRING ST FL 6
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-1522
Country	:	US
Telephone Number	:	855-550-0743
Fax Number	:

Provider Business Practice Location Address
First Line	:	6440 E. PACIFIC COAST HIGHWAY
Second Line	:	SPACE B-165
City	:	LONG BEACH
State	:	CA
Zip	:	90803
Country	:	US
Telephone Number	:	855-550-0743
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	LINDSAY BUXBAUM
Credential	:
Telephone Number	:	855-550-0743

Provider Enumeration Date	:	09/05/2019
Last Update Date	:	06/25/2021

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