Provider Demographics
NPI:1427094093
Name:PRO-SPECS INC
Entity type:Organization
Organization Name:PRO-SPECS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-384-9100
Mailing Address - Street 1:3000 C G ZINN ROAD
Mailing Address - Street 2:THE GREENVIEW PAVILION
Mailing Address - City:THORNDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19372
Mailing Address - Country:US
Mailing Address - Phone:610-380-1621
Mailing Address - Fax:610-380-9765
Practice Address - Street 1:3000 C G ZINN RD
Practice Address - Street 2:THE GREENVIEW PAVILION
Practice Address - City:THORNDALE
Practice Address - State:PA
Practice Address - Zip Code:19372-1134
Practice Address - Country:US
Practice Address - Phone:610-380-1621
Practice Address - Fax:610-380-9765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000005245332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA294164OtherPA BLUE SHIELD
PA1181000001Medicare NSC