Provider Demographics
NPI:1760717961
Name:THE BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP
Entity Type:Organization
Organization Name:THE BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP
Other - Org Name:THE EYE CENTER OPTICAL SHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-966-5582
Mailing Address - Street 1:3020 N SUSQUEHANNA TRL
Mailing Address - Street 2:
Mailing Address - City:SHAMOKIN DAM
Mailing Address - State:PA
Mailing Address - Zip Code:17876-9113
Mailing Address - Country:US
Mailing Address - Phone:570-743-5367
Mailing Address - Fax:570-743-5104
Practice Address - Street 1:3020 N SUSQUEHANNA TRL
Practice Address - Street 2:
Practice Address - City:SHAMOKIN DAM
Practice Address - State:PA
Practice Address - Zip Code:17876-9113
Practice Address - Country:US
Practice Address - Phone:570-743-5367
Practice Address - Fax:570-743-5104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BERNSTEIN HILLIKER HARTZELL EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-06
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332BC3200X332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment