MEDICARE: SCHAEFFER EYE CENTER INC

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1902005192
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHAEFFER EYE CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 1310
Second Line	:
City	:	TRUSSVILLE
State	:	AL
Zip	:	35173-6102
Country	:	US
Telephone Number	:	205-661-2080
Fax Number	:	205-661-2085

Provider Business Practice Location Address
First Line	:	2550 EASTERN BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-1500
Country	:	US
Telephone Number	:	334-274-2020
Fax Number	:	334-396-9924

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	PENNY SMITH
Credential	:
Telephone Number	:	205-661-2080

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	04/21/2010

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Directions to “SCHAEFFER EYE CENTER INC ” Practice Location

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