Provider Demographics
NPI:1912110982
Name:TRI-COUNTY EYE PHYSICIANS & SURGEONS PC
Entity Type:Organization
Organization Name:TRI-COUNTY EYE PHYSICIANS & SURGEONS PC
Other - Org Name:EYE HEALTH OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICAL SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:YEAGER
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:215-230-7666
Mailing Address - Street 1:352 E BUTLER AVE RT 202
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5209
Mailing Address - Country:US
Mailing Address - Phone:215-396-4218
Mailing Address - Fax:215-230-9994
Practice Address - Street 1:352 E BUTLER AVE RT 202
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5209
Practice Address - Country:US
Practice Address - Phone:215-396-4218
Practice Address - Fax:215-230-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006763332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTIN