MEDICARE: VISION 2000, 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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110654	OTHER	KS	BLUE CROSS BLUE SHIELD
2	430800	OTHER	KS	FIRSTGUARD

General Provider Information

NPI Number	:	1871527564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION 2000, LLC

Provider Business Mailing Address
First Line	:	PO BOX 781838
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67278-1838
Country	:	US
Telephone Number	:	877-502-1209
Fax Number	:	877-219-2990

Provider Business Practice Location Address
First Line	:	2021 N AMIDON AVE
Second Line	:	SUITE 13
City	:	WICHITA
State	:	KS
Zip	:	67203-2100
Country	:	US
Telephone Number	:	877-502-1209
Fax Number	:	877-219-2990

Authorized Official
Title or Position	:	CEO
Name	:	MR. ALAN L BURKE
Credential	:
Telephone Number	:	877-502-1209

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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Directions to “VISION 2000, LLC ” Practice Location

Language	Start Address	Practice Location

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