OrganizationWizard Of Eyes, IncOptometristEye and Vision Services ProvidersPractice Address9878 Brewster Ln, Box 108, Powell, OH 43065-7980(614) 619-7973(614) 863-0195PECOS EnrollmentBased on the most recent information from CMS, provider Wizard Of Eyes, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1386057941Provider TypeOrganizationFull NameWizard Of Eyes, IncSubpartNoEnumeration Date6/11/2014Last Updated8/6/2014Contact InformationPractice LocationPractice Address9878 Brewster Ln, Box 108, Powell, OH 43065-7980Phone(614) 619-7973Fax(614) 789-6399Mailing LocationMailing Address2725 S Hamilton Rd, G-5, Columbus, OH 43232-4904Phone(614) 863-0195Fax(614) 863-2701Authorized OfficialNameRoudebush, Mark Desmon (President)Phone(614) 619-7973Provider TaxonomiesCodeDescriptionLicenseCode152W00000XPrimaryDescriptionOptometristEye and Vision Services ProvidersLicense5771OhioProvider IdentifiersIDDescriptionIssuerID0102912DescriptionMedicaidIssuerUnlistedOhio