Provider Demographics
NPI:1558480293
Name:PALMER OPTICAL
Entity Type:Organization
Organization Name:PALMER OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-253-4514
Mailing Address - Street 1:2925 WILLIAM PENN HWY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5283
Mailing Address - Country:US
Mailing Address - Phone:610-253-4514
Mailing Address - Fax:
Practice Address - Street 1:2925 WILLIAM PENN HWY
Practice Address - Street 2:SUITE 306
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5283
Practice Address - Country:US
Practice Address - Phone:610-253-4514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies