Provider Demographics
NPI:1194821397
Name:BENSALEM VISION CARE
Entity Type:Organization
Organization Name:BENSALEM VISION CARE
Other - Org Name:PROCARE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARTRONFT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-638-7438
Mailing Address - Street 1:1953 STREET ROAD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020
Mailing Address - Country:US
Mailing Address - Phone:215-638-7438
Mailing Address - Fax:215-638-8177
Practice Address - Street 1:1953 STREET ROAD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-638-7438
Practice Address - Fax:215-638-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000166152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA060071Medicare PIN
U08074Medicare UPIN