Provider Demographics
NPI:1972581213
Name:ARMESTO EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ARMESTO EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARMESTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-791-2580
Mailing Address - Street 1:2025 TECHNOLOGY PKWY
Mailing Address - Street 2:STE 103
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9400
Mailing Address - Country:US
Mailing Address - Phone:717-791-2580
Mailing Address - Fax:717-791-2588
Practice Address - Street 1:2025 TECHNOLOGY PKWY
Practice Address - Street 2:STE 103
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9400
Practice Address - Country:US
Practice Address - Phone:717-791-2580
Practice Address - Fax:717-791-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000332152WC0802X
PAOEG000271152WC0802X
PAMD046411L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012837890006Medicaid
PA00013949570002Medicaid
PA0019406630003Medicaid
PA054770Medicare PIN
PA0012837890006Medicaid