Provider Demographics
NPI:1679529259
Name:FORT COUCH EYE CARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FORT COUCH EYE CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:HUBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-704-7941
Mailing Address - Street 1:7189 SALTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-2252
Mailing Address - Country:US
Mailing Address - Phone:412-704-7941
Mailing Address - Fax:412-704-7589
Practice Address - Street 1:7189 SALTSBURG RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-2252
Practice Address - Country:US
Practice Address - Phone:412-704-7941
Practice Address - Fax:412-704-7589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000130152W00000X
PAOEG001103152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU33353Medicare UPIN
PA054182RR7Medicare ID - Type Unspecified
PA053142RR7Medicare ID - Type Unspecified
PAU88461Medicare UPIN
PA069916Medicare ID - Type Unspecified