Provider Demographics
NPI:1316127707
Name:CHARLIE J. PARSONS
Entity type:Organization
Organization Name:CHARLIE J. PARSONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-597-7708
Mailing Address - Street 1:50 EASTERN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-1100
Mailing Address - Country:US
Mailing Address - Phone:717-597-7708
Mailing Address - Fax:717-597-1052
Practice Address - Street 1:50 EASTERN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-1100
Practice Address - Country:US
Practice Address - Phone:717-597-7708
Practice Address - Fax:717-597-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000051332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT72394Medicare UPIN