Provider Demographics
NPI:1417991720
Name:CATARACT AND PRIMARY EYE CARE SERVICE, LP
Entity Type:Organization
Organization Name:CATARACT AND PRIMARY EYE CARE SERVICE, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TRINDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-928-3470
Mailing Address - Street 1:840 WALNUT ST
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-928-3900
Mailing Address - Fax:215-928-1772
Practice Address - Street 1:840 WALNUT ST
Practice Address - Street 2:SUITE 1250
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-928-3900
Practice Address - Fax:215-928-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA502160Medicare ID - Type Unspecified