Provider Demographics
NPI:1417135948
Name:JOHN H. MARSTELLER, O.D.
Entity Type:Organization
Organization Name:JOHN H. MARSTELLER, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARSTELLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-665-3276
Mailing Address - Street 1:310 ADELE AVE
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-1214
Mailing Address - Country:US
Mailing Address - Phone:717-665-3276
Mailing Address - Fax:717-665-6128
Practice Address - Street 1:310 ADELE AVE
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-1214
Practice Address - Country:US
Practice Address - Phone:717-665-3276
Practice Address - Fax:717-665-6128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001135332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0651960001Medicare NSC