Provider Demographics
NPI:1073790630
Name:PA EYEWEAR FACTORY INC.
Entity Type:Organization
Organization Name:PA EYEWEAR FACTORY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BESZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-770-0602
Mailing Address - Street 1:2309 MACARTHUR RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-4523
Mailing Address - Country:US
Mailing Address - Phone:610-770-0602
Mailing Address - Fax:610-770-0103
Practice Address - Street 1:2309 MACARTHUR RD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-4523
Practice Address - Country:US
Practice Address - Phone:610-770-0602
Practice Address - Fax:610-770-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA156FX1800X332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier