Provider Demographics
NPI:1780852434
Name:SCHOONOVER EYE CARE, P.C.
Entity Type:Organization
Organization Name:SCHOONOVER EYE CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHOONOVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-489-8733
Mailing Address - Street 1:1339 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452-2055
Mailing Address - Country:US
Mailing Address - Phone:570-489-8733
Mailing Address - Fax:570-489-8702
Practice Address - Street 1:1339 MAIN ST
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452-2055
Practice Address - Country:US
Practice Address - Phone:570-489-8733
Practice Address - Fax:570-489-8702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001610152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
088352Medicare PIN
121633Medicare PIN
PAV03932Medicare UPIN
PADN4180Medicare PIN