Provider Demographics
NPI:1528087608
Name:COMMUNITY EYE CARE ASSOCIATES
Entity type:Organization
Organization Name:COMMUNITY EYE CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-258-7695
Mailing Address - Street 1:811 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2815
Mailing Address - Country:US
Mailing Address - Phone:724-258-7695
Mailing Address - Fax:724-258-7697
Practice Address - Street 1:811 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2815
Practice Address - Country:US
Practice Address - Phone:724-258-7695
Practice Address - Fax:724-258-7697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA410036489OtherRAILROAD MEDICARE
PA1215380001Medicare NSC