MEDICARE: AMERICAN EYEGLASS CENTER 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	137	RI

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	:	1821163494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN EYEGLASS CENTER INC

Provider Business Mailing Address
First Line	:	1365 HARTFORD AVE
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-7134
Country	:	US
Telephone Number	:	401-521-0102
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 HARTFORD AVE
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-7134
Country	:	US
Telephone Number	:	401-521-0102
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. AURELIO QUAGLIERI
Credential	:
Telephone Number	:	401-521-0102

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	08/22/2020

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