Provider Demographics
NPI:1598027419
Name:HSHC-VISION SERVICES
Entity Type:Organization
Organization Name:HSHC-VISION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:FERRANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-629-1353
Mailing Address - Street 1:1843 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-2115
Mailing Address - Country:US
Mailing Address - Phone:215-629-1353
Mailing Address - Fax:866-521-0299
Practice Address - Street 1:1843 S BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2115
Practice Address - Country:US
Practice Address - Phone:215-629-1353
Practice Address - Fax:866-521-0299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002574152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA236789Medicare PIN