1467407312 NPI number — EYE GROUP OF LANCASTER COUNTY, LTD.

Table of content: (NPI 1467407312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467407312 NPI number — EYE GROUP OF LANCASTER COUNTY, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE GROUP OF LANCASTER COUNTY, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467407312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
340 FOREST RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17517-9031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-336-1751
Provider Business Mailing Address Fax Number:
717-336-2478

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
340 FOREST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17517-9031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-336-1751
Provider Business Practice Location Address Fax Number:
717-336-2478
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CALKINS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
LEROY
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
717-336-1751

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD023391E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com