1891908372 NPI number — STONEHENDGE INC.

Table of content: (NPI 1891908372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891908372 NPI number — STONEHENDGE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STONEHENDGE INC.
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:
THE EYE GALLERY OF MT. LEBANON
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:
1891908372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
514 WASHINGTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT LEBANON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228-2826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-344-3930
Provider Business Mailing Address Fax Number:
412-344-3930

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
514 WASHINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15228-2826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-344-3930
Provider Business Practice Location Address Fax Number:
412-344-3930
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DOTY
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
PARKER
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-344-3930

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WC0802X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WS0006X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WV0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WX0102X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: OP0217 02 . This is a "EYE MED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 52166 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1765098 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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