Provider Demographics
NPI:1619092491
Name:HOPE'S VISION EYECARE PROFESSIONALS
Entity Type:Organization
Organization Name:HOPE'S VISION EYECARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:HOPE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-653-5559
Mailing Address - Street 1:925 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552-9546
Mailing Address - Country:US
Mailing Address - Phone:717-653-5559
Mailing Address - Fax:717-653-5598
Practice Address - Street 1:925 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-9546
Practice Address - Country:US
Practice Address - Phone:717-653-5559
Practice Address - Fax:717-653-5598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG00063152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA531700UD0Medicare ID - Type Unspecified
PAU51464Medicare UPIN