Provider Demographics
NPI:1225250566
Name:B & C EYEGLASS FACTORY
Entity Type:Organization
Organization Name:B & C EYEGLASS FACTORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-896-4540
Mailing Address - Street 1:50 E WYNNEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2013
Mailing Address - Country:US
Mailing Address - Phone:610-896-4542
Mailing Address - Fax:610-896-4542
Practice Address - Street 1:50 E WYNNEWOOD RD
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2013
Practice Address - Country:US
Practice Address - Phone:610-896-4542
Practice Address - Fax:610-896-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000000032152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
38646OtherDAVIS VISION PLAN
01495OtherSPECTERA
01495OtherAMERICHOICE VISION PLAN
38646OtherDAVIS VISION PLAN