MEDICARE: EYES 2020 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	156FX1800X	Optician

General Provider Information

NPI Number	:	1750607909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES 2020 INC.

Provider Business Mailing Address
First Line	:	4292 PORTERFIELD RD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-8604
Country	:	US
Telephone Number	:	765-962-9898
Fax Number	:	765-962-3944

Provider Business Practice Location Address
First Line	:	3757 E MAIN ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-3614
Country	:	US
Telephone Number	:	765-935-4193
Fax Number	:	765-935-4410

Authorized Official
Title or Position	:	OWNER
Name	:	BRITNEY LOUISE PRIEST
Credential	:
Telephone Number	:	765-962-9898

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	04/13/2010

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