| |
120 5th Ave Fl 1, Pittsburgh, PA 15222-3000 | |
(412) 471-1306 | |
(412) 471-1896 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 120 5th Ave Fl 1, Pittsburgh, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659334175 | NPI | - | NPPES |
0017630120013 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
156F00000X | Technician/technologist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 418348, Boston, MA 02241-8348 Ph: (210) 524-6663 | 120 5th Ave Fl 1, Pittsburgh, PA 15222-3000 Ph: (412) 471-1306 |