Provider Demographics
NPI:1962917393
Name:VANTAGE EYECARE, LLC
Entity type:Organization
Organization Name:VANTAGE EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, LEAD PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-396-4211
Mailing Address - Street 1:360 MIDDLETOWN BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1863
Mailing Address - Country:US
Mailing Address - Phone:215-757-6200
Mailing Address - Fax:215-750-7875
Practice Address - Street 1:360 MIDDLETOWN BLVD STE 402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1863
Practice Address - Country:US
Practice Address - Phone:215-757-6200
Practice Address - Fax:215-750-7875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies