Provider Demographics
NPI:1265638886
Name:LEONARDI GROUP, INC
Entity Type:Organization
Organization Name:LEONARDI GROUP, INC
Other - Org Name:SHAWNEE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-838-2020
Mailing Address - Street 1:2203 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4501
Mailing Address - Country:US
Mailing Address - Phone:814-838-2020
Mailing Address - Fax:814-838-9216
Practice Address - Street 1:1689 N BECHTLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1568
Practice Address - Country:US
Practice Address - Phone:937-323-1233
Practice Address - Fax:937-323-2518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5007270007Medicare NSC