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NPI Code Detail

MEDICARE: EPIC VISION LLC

MEDICARE: EPIC VISION 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
1152W00000XOptometrist2006023500MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871831446
Entity Type Code : Organization
Provider Name (Legal Business Name) : EPIC VISION LLC
Provider Business Mailing Address
First Line : PO BOX 1095
Second Line :
City : SMITHVILLE
State : MO
Zip : 64089-1095
Country : US
Telephone Number : 816-587-1320
Fax Number : 816-587-7485
Provider Business Practice Location Address
First Line : 6400 N COSBY AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64151-2377
Country : US
Telephone Number : 816-587-1320
Fax Number : 816-587-7485
Authorized Official
Title or Position : MEMBER
Name : DR. THOMAS L ANDERSON
Credential : O.D.
Telephone Number : 816-873-0202
Provider Enumeration Date : 01/16/2013
Last Update Date : 01/16/2013

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Directions to “EPIC VISION LLC ” Practice Location

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