MEDICARE: FOCUS EYECARE CENTER PC

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	18003059A	IN

General Provider Information

NPI Number	:	1780766642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS EYECARE CENTER PC

Provider Business Mailing Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	SUITE 4
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-9944
Fax Number	:	812-944-8990

Provider Business Practice Location Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	SUITE 4
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-9944
Fax Number	:	812-944-8990

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GRANT CAMERON AMSTUTZ
Credential	:	O.D.
Telephone Number	:	812-944-9944

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	12/01/2010

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