Provider Demographics
NPI:1548603939
Name:INSTITUTIONAL EYE CARE
Entity Type:Organization
Organization Name:INSTITUTIONAL EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTHALMIC TECH
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KANOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-592-4915
Mailing Address - Street 1:2120 HIGHVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1105
Mailing Address - Country:US
Mailing Address - Phone:814-592-4915
Mailing Address - Fax:
Practice Address - Street 1:41 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1944
Practice Address - Country:US
Practice Address - Phone:866-604-2931
Practice Address - Fax:570-524-2817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic AssistantGroup - Single Specialty