MEDICARE: CEDAR SPRINGS EYE CARE 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	152W00000X	Optometrist	4901003121	MI

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	:	1598934150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR SPRINGS EYE CARE INC

Provider Business Mailing Address
First Line	:	26 S MAIN
Second Line	:	P.O. BOX 683
City	:	CEDAR SPRINGS
State	:	MI
Zip	:	49319-8936
Country	:	US
Telephone Number	:	616-696-0830
Fax Number	:	616-696-4724

Provider Business Practice Location Address
First Line	:	26 S MAIN
Second Line	:
City	:	CEDAR SPRINGS
State	:	MI
Zip	:	49319-5118
Country	:	US
Telephone Number	:	616-696-0830
Fax Number	:	616-696-4724

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. SCOTT L SCHOMAKER
Credential	:	O.D.
Telephone Number	:	616-696-0830

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	03/08/2013

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Directions to “CEDAR SPRINGS EYE CARE INC ” Practice Location

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