Provider Demographics
NPI:1942516612
Name:PHILIP J. SCHAVILLE, O.D., P.C.
Entity Type:Organization
Organization Name:PHILIP J. SCHAVILLE, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHAVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-658-4505
Mailing Address - Street 1:2824 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1232
Mailing Address - Country:US
Mailing Address - Phone:724-658-4505
Mailing Address - Fax:724-658-5593
Practice Address - Street 1:2824 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1232
Practice Address - Country:US
Practice Address - Phone:724-658-4505
Practice Address - Fax:724-658-5593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000380152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA053153Medicare UPIN