MEDICARE: R&S PRODUCTION & GLASSES FOR LESS

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

Other Identifiers

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

General Provider Information

NPI Number	:	1932388428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R&S PRODUCTION & GLASSES FOR LESS

Provider Business Mailing Address
First Line	:	133 S MAIN ST
Second Line	:
City	:	ARAB
State	:	AL
Zip	:	35016-1354
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 S MAIN ST
Second Line	:
City	:	ARAB
State	:	AL
Zip	:	35016-1354
Country	:	US
Telephone Number	:	256-931-4994
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT LESTER BALLEW III
Credential	:
Telephone Number	:	256-931-4994

Provider Enumeration Date	:	10/31/2007
Last Update Date	:	06/27/2008

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