Provider Demographics
NPI:1629010301
Name:CLOMPUS AND RETO VISION P C
Entity Type:Organization
Organization Name:CLOMPUS AND RETO VISION P C
Other - Org Name:CLOMPUS, RETO & HALSCHEID VISION ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RETO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-696-1368
Mailing Address - Street 1:1450 E BOOT RD
Mailing Address - Street 2:BUILDING 700B
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5300
Mailing Address - Country:US
Mailing Address - Phone:610-696-1368
Mailing Address - Fax:610-430-2079
Practice Address - Street 1:1450 E BOOT RD
Practice Address - Street 2:BUILDING 700B
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5300
Practice Address - Country:US
Practice Address - Phone:610-696-1368
Practice Address - Fax:610-430-2079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0619660001Medicare NSC
PA591899Medicare PIN