Provider Demographics
NPI:1346414794
Name:ANDINO EYE CARE, INC.
Entity Type:Organization
Organization Name:ANDINO EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDINO
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:724-843-2025
Mailing Address - Street 1:2560 DARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1254
Mailing Address - Country:US
Mailing Address - Phone:724-843-2025
Mailing Address - Fax:
Practice Address - Street 1:2560 DARLINGTON RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1254
Practice Address - Country:US
Practice Address - Phone:724-843-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001295152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAN138222OtherHIGHMARK -ANDINO EYE CARE
PA138222Medicare PIN