Provider Demographics
NPI:1326185182
Name:MORRELL EYE CARE, INC.
Entity Type:Organization
Organization Name:MORRELL EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-632-6698
Mailing Address - Street 1:3810 MORRELL AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1915
Mailing Address - Country:US
Mailing Address - Phone:215-632-6698
Mailing Address - Fax:215-632-9979
Practice Address - Street 1:3810 MORRELL AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1915
Practice Address - Country:US
Practice Address - Phone:215-632-6698
Practice Address - Fax:215-632-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA144573332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0129200001Medicare NSC
PA0129200001Medicare PIN