MEDICARE: CENTER OPTICAL COMPANY

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	:	1861528333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER OPTICAL COMPANY

Provider Business Mailing Address
First Line	:	728 W 11 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3206
Country	:	US
Telephone Number	:	248-541-8686
Fax Number	:	248-545-4999

Provider Business Practice Location Address
First Line	:	728 W 11 MILE RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3206
Country	:	US
Telephone Number	:	248-541-8686
Fax Number	:	248-545-4999

Authorized Official
Title or Position	:	OPTICIAN OWNER
Name	:	DONNA M TARNAS
Credential	:
Telephone Number	:	248-541-8686

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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Directions to “CENTER OPTICAL COMPANY ” Practice Location

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