1851372445 NPI number — DR. REBECCA MORFORD O.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851372445 NPI number — DR. REBECCA MORFORD O.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MORFORD

Provider First Name:

REBECCA

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

O.D.

Provider Gender Code:

F

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:

1851372445

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/07/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

190 BEACON RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

RENFREW

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

16053-1206

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

724-822-6179

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

101 CLEARVIEW CIR

Provider Second Line Business Practice Location Address:

BOSCOV'S OPTICAL

Provider Business Practice Location Address City Name:

BUTLER

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

16001-1576

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

724-285-2139

Provider Business Practice Location Address Fax Number:

724-283-2084

Provider Enumeration Date:

11/09/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 152W00000X , with the licence number:  OEG001301 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 03831-001 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 205052/102386 . This is a "EYEMED/ COLE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 656619 . This is a "BC/BS INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2529139 . This is a "AETNA INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 106109 . This is a "BC/BS GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 396975 . This is a "NVA GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 01611137 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2077435 . This is a "AETNA GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0017950990002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 2518269522A12 . This is a "ANTHEM PIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0016689/ 014829 . This is a "DORAL VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2518269522A00 . This is a "ANTHEM GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".