Provider Demographics
NPI:1962580084
Name:WATSON'S OPTICAL INC.
Entity type:Organization
Organization Name:WATSON'S OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-242-2721
Mailing Address - Street 1:50 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1851
Mailing Address - Country:US
Mailing Address - Phone:717-242-2721
Mailing Address - Fax:717-242-3510
Practice Address - Street 1:50 VALLEY ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1851
Practice Address - Country:US
Practice Address - Phone:717-242-2721
Practice Address - Fax:717-242-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA288845OtherBLUE SHIELD
PA0008462640001Medicaid
PA288845OtherBLUE SHIELD
PA0008462640001Medicaid