Provider Demographics
NPI:1164500229
Name:TRI-STATE FAMILY EYE CARE, INC.
Entity Type:Organization
Organization Name:TRI-STATE FAMILY EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LEONNE
Authorized Official - Last Name:ELCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-284-0777
Mailing Address - Street 1:538 CHURCH LANE
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3102
Mailing Address - Country:US
Mailing Address - Phone:610-284-0777
Mailing Address - Fax:
Practice Address - Street 1:538 CHURCH LANE
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3102
Practice Address - Country:US
Practice Address - Phone:610-284-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty