Provider Demographics
NPI:1992982318
Name:DR RONALD POGACH
Entity type:Organization
Organization Name:DR RONALD POGACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:POGACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-994-3300
Mailing Address - Street 1:5503 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5001
Mailing Address - Country:US
Mailing Address - Phone:302-994-3300
Mailing Address - Fax:302-994-3782
Practice Address - Street 1:5503 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5001
Practice Address - Country:US
Practice Address - Phone:302-994-3300
Practice Address - Fax:302-994-3782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DET-26918Medicare UPIN