MEDICARE: AUGUSTA EYE ASSOCIATES, PLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	0101246846	VA

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	:	1831414606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUGUSTA EYE ASSOCIATES, PLC

Provider Business Mailing Address
First Line	:	17 N MEDICAL PARK DR
Second Line	:
City	:	FISHERSVILLE
State	:	VA
Zip	:	22939-2344
Country	:	US
Telephone Number	:	540-213-7721
Fax Number	:	540-213-7728

Provider Business Practice Location Address
First Line	:	62 HILL TOP LN
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-5726
Country	:	US
Telephone Number	:	540-463-4140
Fax Number	:	540-458-0035

Authorized Official
Title or Position	:	CLIENT SERVICES COORDINATOR
Name	:	LAURA M TALLEY
Credential	:
Telephone Number	:	540-213-7725

Provider Enumeration Date	:	04/05/2010
Last Update Date	:	04/05/2010

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