Provider Demographics
NPI:1477610988
Name:WEST PENN OPTICAL INC.
Entity Type:Organization
Organization Name:WEST PENN OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN. MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-833-1194
Mailing Address - Street 1:2576 WEST 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505
Mailing Address - Country:US
Mailing Address - Phone:814-833-1194
Mailing Address - Fax:814-838-9530
Practice Address - Street 1:2576 WEST 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505
Practice Address - Country:US
Practice Address - Phone:814-833-1194
Practice Address - Fax:814-838-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA53180OtherDAVIS VISION
PAWE1350395OtherBLUE CROSS BLUE SHIELD
PA0278990001Medicare NSC
PA53180OtherDAVIS VISION