MEDICARE: CENTRAL OHIO EYE SURGEONS 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	35062506	OH

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	:	1588940050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL OHIO EYE SURGEONS INC

Provider Business Mailing Address
First Line	:	1501 CHESTNUT ST
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-1436
Country	:	US
Telephone Number	:	740-397-2425
Fax Number	:	740-392-1915

Provider Business Practice Location Address
First Line	:	1501 CHESTNUT ST
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-1436
Country	:	US
Telephone Number	:	740-397-2425
Fax Number	:	740-392-1915

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEBBIE S BARTRAM
Credential	:
Telephone Number	:	740-397-2425

Provider Enumeration Date	:	10/28/2011
Last Update Date	:	10/10/2012

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