Provider Demographics
NPI:1275599425
Name:DR. GARY ANDRUS AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:DR. GARY ANDRUS AND ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRUS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-337-4055
Mailing Address - Street 1:160 N GULPH RD
Mailing Address - Street 2:SUITE 2026
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2937
Mailing Address - Country:US
Mailing Address - Phone:610-337-4055
Mailing Address - Fax:
Practice Address - Street 1:160 N GULPH RD
Practice Address - Street 2:SUITE 2026
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19406-2937
Practice Address - Country:US
Practice Address - Phone:610-337-4055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001139152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64753Medicare UPIN
V02728Medicare UPIN