Provider Demographics
NPI:1164477907
Name:VISION CARE SPECIALISTS INC
Entity Type:Organization
Organization Name:VISION CARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:CADWALLADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-536-8540
Mailing Address - Street 1:361 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-1414
Mailing Address - Country:US
Mailing Address - Phone:215-536-8540
Mailing Address - Fax:215-536-8117
Practice Address - Street 1:361 S 11TH ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1414
Practice Address - Country:US
Practice Address - Phone:215-536-8540
Practice Address - Fax:215-536-8117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0652912000OtherINDEPENDENCE BLUE CROSS
PAVI388885OtherHIGHMARK BLUE SHIELD
PA0924950001Medicare NSC