Organization Name: | RUSSELL EYECARE INC. |
NPI Number: | 1033404900 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRY DAVID RUSSELL (PRESIDENT/ OPTOMETRIST) |
Mailing Address: | 1450 Morrell Ave Connellsville |
State: | PA US |
Postal Code: | 154253809 |
Phone Number: | 7246264486 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2011 |
NPI Last Update Date: | 06/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | OEG000421 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |