Provider Demographics
NPI:1770682387
Name:THOMAS S PHILLIPS ODPC
Entity Type:Organization
Organization Name:THOMAS S PHILLIPS ODPC
Other - Org Name:DR PHILLIPS EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMITRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-674-2020
Mailing Address - Street 1:179 YORK RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4514
Mailing Address - Country:US
Mailing Address - Phone:215-674-2020
Mailing Address - Fax:215-674-4323
Practice Address - Street 1:179 YORK RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-4514
Practice Address - Country:US
Practice Address - Phone:215-674-2020
Practice Address - Fax:215-674-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG00901152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU19701Medicare UPIN
PA103694Medicare PIN