Provider Demographics
NPI:1932233681
Name:KIRN FAMILY EYECARE
Entity Type:Organization
Organization Name:KIRN FAMILY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:WHITE
Authorized Official - Last Name:KIRN
Authorized Official - Suffix:
Authorized Official - Credentials:OD MS
Authorized Official - Phone:717-657-5030
Mailing Address - Street 1:2151 LINGLESTOWN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9499
Mailing Address - Country:US
Mailing Address - Phone:717-657-5030
Mailing Address - Fax:
Practice Address - Street 1:2151 LINGLESTOWN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-9499
Practice Address - Country:US
Practice Address - Phone:717-657-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000766 PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02123201OtherKEYSTONE HEALTH PLAN
PADA784868OtherOPTICHOICE
PA01220701OtherKEYSTONE HEALTH PLAN
PA36920OtherDAVIS VISION
PA369530OtherNATIONAL VISION ADMINISTR
PA077395Medicare ID - Type Unspecified