Provider Demographics
NPI:1609805266
Name:DR. ALBERT J. HOFFMAN, INC.
Entity Type:Organization
Organization Name:DR. ALBERT J. HOFFMAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-593-4005
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-0117
Mailing Address - Country:US
Mailing Address - Phone:440-593-4005
Mailing Address - Fax:440-593-5706
Practice Address - Street 1:237 SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2525
Practice Address - Country:US
Practice Address - Phone:440-593-4005
Practice Address - Fax:440-593-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3540 T235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH82693OtherAMERI HEALTH --DAVIS VISI
OH001540173OtherHIGHMARK BC/BS
OH0545048Medicaid
OH9H271HOOtherBC/BS MINNESOTA
OH000000132058OtherANTHEM BC
OH000000132058OtherANTHEM BC
OH0426810001Medicare NSC
OH82693OtherAMERI HEALTH --DAVIS VISI
OH001540173OtherHIGHMARK BC/BS