Provider Demographics
NPI:1164423869
Name:EPHRATA FAMILY EYE CARE LLP
Entity Type:Organization
Organization Name:EPHRATA FAMILY EYE CARE LLP
Other - Org Name:THE OPTIC SHOPPE
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BENSING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-738-2488
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:101 E MAIN STREET
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-0699
Mailing Address - Country:US
Mailing Address - Phone:717-738-2488
Mailing Address - Fax:717-721-9088
Practice Address - Street 1:101 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2710
Practice Address - Country:US
Practice Address - Phone:717-738-2488
Practice Address - Fax:717-721-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000376 OEG000476152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1289040001Medicare NSC
PA028869Medicare PIN