1437219169 NPI number — DR. DON THOMAS COLE O.D.

Table of content: DR. DON THOMAS COLE O.D. (NPI 1437219169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437219169 NPI number — DR. DON THOMAS COLE O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLE
Provider First Name:
DON
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
M

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:
1437219169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4522 BROADWAY BLVD
Provider Second Line Business Mailing Address:
HAYMAKER VILLAGE
Provider Business Mailing Address City Name:
MONROEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15146-4745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-373-8670
Provider Business Mailing Address Fax Number:
412-373-5053

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4522 BROADWAY BLVD
Provider Second Line Business Practice Location Address:
HAYMAKER VILLAGE
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-4745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-373-8670
Provider Business Practice Location Address Fax Number:
412-373-5053
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  5488 , 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: 0017525 . This is a "DORAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50721 . This is a "DAVIS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 410001408 . This is a "MEDICARE - RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1437219169 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5488 . This is a "VISION BENEFITS OF AMERIC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000074811 . This is a "KEYSTONE BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 251400459 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 74811 . This is a "HIGHMARK MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CO74811 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000557038002 . This is a "PROMISE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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