MEDICARE: EDINBURGH EYE CARE LLC

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	0618001467	VA

General Provider Information

NPI Number	:	1821462680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDINBURGH EYE CARE LLC

Provider Business Mailing Address
First Line	:	236 CARMICHAEL WAY
Second Line	:	SUITE 318
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-2185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	236 CARMICHAEL WAY
Second Line	:	SUITE 318
City	:	CHESAPEAKE
State	:	VA
Zip	:	23322-2185
Country	:	US
Telephone Number	:	757-368-3937
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. RAHIM KANJI
Credential	:	OD
Telephone Number	:	407-342-7273

Provider Enumeration Date	:	11/17/2015
Last Update Date	:	11/17/2015

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