Provider Demographics
NPI:1942495379
Name:FINNCO INCORPORATED
Entity Type:Organization
Organization Name:FINNCO INCORPORATED
Other - Org Name:DR. GARY FINNEGAN-OPTOMETRIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:FINNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:570-387-0991
Mailing Address - Street 1:1901 COLUMBIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-7750
Mailing Address - Country:US
Mailing Address - Phone:570-387-0991
Mailing Address - Fax:
Practice Address - Street 1:1901 COLUMBIA BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-7750
Practice Address - Country:US
Practice Address - Phone:570-387-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000286152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001605158-002Medicaid
PA136265Medicare PIN
PAU57790Medicare UPIN
PA001605158-002Medicaid