Provider Demographics
NPI:1427483742
Name:CASSEYS OPTICAL INC
Entity type:Organization
Organization Name:CASSEYS OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:CASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-955-1082
Mailing Address - Street 1:139 S STATE ROAD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064
Mailing Address - Country:US
Mailing Address - Phone:610-543-8200
Mailing Address - Fax:
Practice Address - Street 1:139 S STATE ROAD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064
Practice Address - Country:US
Practice Address - Phone:610-543-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006220332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1821035759Medicare NSC