1780896878 NPI number — ROBINSON EYE CENTER LLC

Table of content: (NPI 1780896878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780896878 NPI number — ROBINSON EYE CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBINSON EYE CENTER LLC
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:
1780896878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
180 IMPERIAL PLAZA DR
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
IMPERIAL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15126-9331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-695-5510
Provider Business Mailing Address Fax Number:
724-695-8510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
180 IMPERIAL PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
IMPERIAL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15126-9331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-695-5510
Provider Business Practice Location Address Fax Number:
724-695-8510
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GOUNDER
Authorized Official First Name:
RAMAKUMAR
Authorized Official Middle Name:
NATARAJAN
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
724-695-5510

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  MD417220 , 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: 01600717586 . This is a "DORAL PROVIDER & LOCATION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 43030 . This is a "DAVIS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA7220 . This is a "EYEMED COLE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: PA17220 . This is a "VBA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7589430 . This is a "AETNA PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019431640001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3039591 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 312055 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000142774 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000211356 . This is a "HEALTH AM AS ADV" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001436147 . This is a "HIGHMARK BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7732705 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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