Provider Demographics
NPI:1972535292
Name:CATARACT AND LASER SURGERY CENTER
Entity Type:Organization
Organization Name:CATARACT AND LASER SURGERY CENTER
Other - Org Name:THE OPHTHALMOLOGY & SURGICAL INSTITUTE OF CENTRAL PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:717-249-0745
Mailing Address - Street 1:338 ALEXANDER SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9129
Mailing Address - Country:US
Mailing Address - Phone:717-249-0745
Mailing Address - Fax:717-249-0943
Practice Address - Street 1:5 TYLER CT
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-7671
Practice Address - Country:US
Practice Address - Phone:717-249-0745
Practice Address - Fax:717-249-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1800261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015252100001Medicaid
PA1015252100001Medicaid