Provider Demographics
NPI:1407814122
Name:SCHONHOFEN OPTOMETRY PA
Entity Type:Organization
Organization Name:SCHONHOFEN OPTOMETRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:336-835-1312
Mailing Address - Street 1:346 N BRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-3407
Mailing Address - Country:US
Mailing Address - Phone:336-835-1312
Mailing Address - Fax:336-835-9911
Practice Address - Street 1:346 N BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-3407
Practice Address - Country:US
Practice Address - Phone:336-835-1312
Practice Address - Fax:336-835-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0981KOtherBCBS
107556OtherTRIGON BCBS MEDIGAP
NC180004950OtherRAILROAD PROVIDER
NC890981KMedicaid
NC0981KOtherBCBS
107556OtherTRIGON BCBS MEDIGAP