1235350133 NPI number — THE EYE GALLERY INC.

Table of content: (NPI 1235350133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235350133 NPI number — THE EYE GALLERY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE EYE GALLERY 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:
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:
1235350133
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 E MCMURRAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCMURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-3419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-941-3930
Provider Business Mailing Address Fax Number:
724-941-1787

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
609 E MCMURRAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCMURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-3419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-941-3930
Provider Business Practice Location Address Fax Number:
724-941-1787
Provider Enumeration Date:
05/01/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DOTY
Authorized Official First Name:
PARKER
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-941-3930

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: 592680 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017386 . This is a "DORAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 44750 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 393668 . This is a "NVA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: OP0217 . This is a "EYE MED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".