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NPI Code Detail

MEDICARE: USV OPTICAL, INC.

MEDICARE: USV OPTICAL, 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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1588161285
Entity Type Code : Organization
Provider Name (Legal Business Name) : USV OPTICAL, INC.
Provider Business Mailing Address
First Line : 1 HARMON DR
Second Line :
City : BLACKWOOD
State : NJ
Zip : 08012-5103
Country : US
Telephone Number : 856-228-1000
Fax Number : 856-718-3572
Provider Business Practice Location Address
First Line : 9770 S MARYLAND PKWY STE 10
Second Line :
City : LAS VEGAS
State : NV
Zip : 89183-7143
Country : US
Telephone Number : 702-492-0719
Fax Number :
Authorized Official
Title or Position : PROFESSIONAL RELATIONS MANAGER
Name : RANDI WOERNER
Credential :
Telephone Number : 856-228-1000
Provider Enumeration Date : 04/09/2018
Last Update Date : 01/27/2020

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