MEDICARE: FOCUS ON EYECARE 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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1902543556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOCUS ON EYECARE LLC

Provider Business Mailing Address
First Line	:	1005 BEAVER GRADE RD STE G10
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2964
Country	:	US
Telephone Number	:	412-308-9111
Fax Number	:	412-308-9112

Provider Business Practice Location Address
First Line	:	1005 BEAVER GRADE RD STE G10
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2964
Country	:	US
Telephone Number	:	412-308-9111
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MICHELLE WERTELET
Credential	:	OD
Telephone Number	:	412-308-9111

Provider Enumeration Date	:	05/16/2022
Last Update Date	:	06/27/2022

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