Provider Demographics
NPI:1942488713
Name:GARY L SCHEIB
Entity Type:Organization
Organization Name:GARY L SCHEIB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:SCHEIB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-622-3937
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-0420
Mailing Address - Country:US
Mailing Address - Phone:570-622-3937
Mailing Address - Fax:570-622-3431
Practice Address - Street 1:307 MAHANTONGO ST
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3061
Practice Address - Country:US
Practice Address - Phone:570-622-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEGOO1179332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29419Medicare UPIN
PASC131682Medicare UPIN
PA0427410002Medicare NSC
PA0427410001Medicare NSC