Provider Demographics
NPI:1487662094
Name:PACH, BERNARD M (OD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:M
Last Name:PACH
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:COVENTRY MALL
Mailing Address - Street 2:ROUTE 724
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465
Mailing Address - Country:US
Mailing Address - Phone:610-327-3322
Mailing Address - Fax:610-327-0906
Practice Address - Street 1:351 W SCHUYLKILL RD
Practice Address - Street 2:PEARLE VISION
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465
Practice Address - Country:US
Practice Address - Phone:610-327-3322
Practice Address - Fax:610-327-0906
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA0E005278T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00879962Medicaid
PA00879962Medicaid