MEDICARE: SVS VISION 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
2	152W00000X	Optometrist

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	MI1465	OTHER	MI	PTAN

General Provider Information

NPI Number	:	1609140680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SVS VISION INC

Provider Business Mailing Address
First Line	:	118 CASS AVE
Second Line	:
City	:	MOUNT CLEMENS
State	:	MI
Zip	:	48043-2204
Country	:	US
Telephone Number	:	586-464-1479
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 TELEGRAPH RD
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3012
Country	:	US
Telephone Number	:	248-419-3500
Fax Number	:	248-419-3503

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. ROBERT G FARRELL JR.
Credential	:	OD
Telephone Number	:	586-468-7370

Provider Enumeration Date	:	03/08/2012
Last Update Date	:	06/28/2023

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Directions to “SVS VISION INC ” Practice Location

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