Provider Demographics
NPI:1780672956
Name:CHARLIE J PARSONS
Entity Type:Organization
Organization Name:CHARLIE J PARSONS
Other - Org Name:GREENCASTLE EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-597-7708
Mailing Address - Street 1:50 EASTERN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1100
Mailing Address - Country:US
Mailing Address - Phone:717-597-7708
Mailing Address - Fax:717-597-1052
Practice Address - Street 1:50 EASTERN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-1100
Practice Address - Country:US
Practice Address - Phone:717-597-7708
Practice Address - Fax:717-597-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000051152W00000X
PAOEG001097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1426790OtherHIGHMARK BLUE SHIELD
PA1535610OtherAETNA HMO
PA02450500OtherCAPITOL BLUE CROSS
PA833045OtherAETNA, HMO
PA5187071OtherAETNA, PPO
PA5935579OtherAETNA PPO
PADF9974OtherRAILROAD MEDICARE
PA5187071OtherAETNA, PPO
PA072545Medicare ID - Type Unspecified