MEDICARE: SOUTHWESTERN EYE CENTERS, 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	332H00000X	Eyewear Supplier

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	:	1952732992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWESTERN EYE CENTERS, LLC

Provider Business Mailing Address
First Line	:	203 N REDWOOD ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1668
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Provider Business Practice Location Address
First Line	:	203 N REDWOOD ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1668
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. DAVID P ALAN
Credential	:	OD
Telephone Number	:	724-583-7793

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	12/02/2013

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Directions to “SOUTHWESTERN EYE CENTERS, LLC ” Practice Location

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