Provider Demographics
NPI:1942738687
Name:SIGHTLINE SURGICAL REFRACTIVE SUITE PC
Entity Type:Organization
Organization Name:SIGHTLINE SURGICAL REFRACTIVE SUITE PC
Other - Org Name:SIGHTLINE SURGICAL REFRACTIVE SUITE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-933-5588
Mailing Address - Street 1:2591 WEXFORD BAYNE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8676
Mailing Address - Country:US
Mailing Address - Phone:724-933-5588
Mailing Address - Fax:
Practice Address - Street 1:2591 WEXFORD BAYNE RD STE 100
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8676
Practice Address - Country:US
Practice Address - Phone:724-933-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical