1235159757 NPI number — MAY EYE CARE PC

Table of content: (NPI 1235159757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235159757 NPI number — MAY EYE CARE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAY EYE CARE PC
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:
6
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:
1235159757
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 FAME AVENUE
Provider Second Line Business Mailing Address:
SUITE 225
Provider Business Mailing Address City Name:
HANOVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-637-1919
Provider Business Mailing Address Fax Number:
717-637-2326

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 FAME AVENUE
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
HANOVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-637-1919
Provider Business Practice Location Address Fax Number:
717-637-2326
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAY
Authorized Official First Name:
CARL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
717-637-1919

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  MD052846L , 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)

  • Identifier: 03083400 . This is a "CAPITAL BLUE CROSS GRP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 573524 . This is a "PA BS GRP#OPHTHALMOLOGY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1432309 . This is a "PA BS OPTOMETRY GRP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CK5487 . This is a "RAILROAD MEDICARE GRP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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