1366539694 NPI number — ROBERT A BARCLAY & ARTAMARIE S.

Table of content: (NPI 1366539694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366539694 NPI number — ROBERT A BARCLAY & ARTAMARIE S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT A BARCLAY & ARTAMARIE S.
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:
FAMILY EYE AND VISION CARE
Provider Other Organization Name Type Code:
3
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:
1366539694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
314 9TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGDON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16652-1804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-643-4500
Provider Business Mailing Address Fax Number:
814-643-2938

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
314 NINTH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652-1804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-643-4500
Provider Business Practice Location Address Fax Number:
814-643-2938
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARCLAY
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
814-643-4500

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG000631 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: OEG000630 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 733088 . This is a "MEDICARE ID-TYPE UNSPECIFIED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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