Provider Demographics
NPI:1922461466
Name:PHILLY VISION CARE LLC
Entity Type:Organization
Organization Name:PHILLY VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-522-8821
Mailing Address - Street 1:1936 DELMAR DR
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-1401
Mailing Address - Country:US
Mailing Address - Phone:610-522-8821
Mailing Address - Fax:610-522-8795
Practice Address - Street 1:1936 DELMAR DR
Practice Address - Street 2:
Practice Address - City:FOLCROFT
Practice Address - State:PA
Practice Address - Zip Code:19032-1401
Practice Address - Country:US
Practice Address - Phone:610-522-8821
Practice Address - Fax:610-522-8795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier