Provider Demographics
NPI:1386793644
Name:OLDE TOWNE OPTICIANS INC.
Entity type:Organization
Organization Name:OLDE TOWNE OPTICIANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:717-393-4375
Mailing Address - Street 1:438 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4927
Mailing Address - Country:US
Mailing Address - Phone:717-393-4375
Mailing Address - Fax:
Practice Address - Street 1:438 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4927
Practice Address - Country:US
Practice Address - Phone:717-393-4375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty