Provider Demographics
NPI:1790793842
Name:SCHWENKSVILLE EYE ASSOCIATES
Entity Type:Organization
Organization Name:SCHWENKSVILLE EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-287-7160
Mailing Address - Street 1:1000 GRAVEL PIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SCHWENKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19473-2364
Mailing Address - Country:US
Mailing Address - Phone:610-287-7160
Mailing Address - Fax:610-287-1160
Practice Address - Street 1:1000 GRAVEL PIKE
Practice Address - Street 2:SUITE 300
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-2364
Practice Address - Country:US
Practice Address - Phone:610-287-7160
Practice Address - Fax:610-287-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX ID