Provider Demographics
NPI:1235397480
Name:BARRETT VISION CENTER INC
Entity Type:Organization
Organization Name:BARRETT VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHADNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-943-4710
Mailing Address - Street 1:515 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2026
Mailing Address - Country:US
Mailing Address - Phone:814-943-4710
Mailing Address - Fax:814-943-3721
Practice Address - Street 1:515 26TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-2026
Practice Address - Country:US
Practice Address - Phone:814-943-4710
Practice Address - Fax:814-943-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014389170003Medicaid
PA0014389170003Medicaid