Provider Demographics
NPI:1013998079
Name:FARRELL AQUISITION CORPORATION
Entity Type:Organization
Organization Name:FARRELL AQUISITION CORPORATION
Other - Org Name:ARLINGTON OPTICAL, LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-652-4924
Mailing Address - Street 1:4386 STURBRIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3668
Mailing Address - Country:US
Mailing Address - Phone:717-652-4924
Mailing Address - Fax:717-652-1015
Practice Address - Street 1:4386 STURBRIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3886
Practice Address - Country:US
Practice Address - Phone:717-652-4924
Practice Address - Fax:717-652-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0614458OtherKEYSTONE
OP1605OtherEYE MED
50025282OtherCAPITAL BLUE CROSS
68052259AOtherTAX ID
39808OtherGEISINGER GOLD
1429299OtherBLUE SHIELD VISION
393570OtherNVA
39808OtherGEISINGER
0614458OtherSENIOR BLUE
1429299OtherHIGHMARK
5766476OtherAETNA
1429299OtherBLUE SHIELD VISION
PA4756730001Medicare NSC