Provider Demographics
NPI:1649759572
Name:CABLE EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CABLE EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:717-532-7893
Mailing Address - Street 1:871C W KING ST
Mailing Address - Street 2:
Mailing Address - City:SHIPPENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17257-9201
Mailing Address - Country:US
Mailing Address - Phone:717-532-7893
Mailing Address - Fax:717-532-8521
Practice Address - Street 1:871C W KING ST
Practice Address - Street 2:
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-9201
Practice Address - Country:US
Practice Address - Phone:717-532-7893
Practice Address - Fax:717-532-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000029152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1902883432OtherNPI