Organization Name: | THE BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP |
NPI Number: | 1114327343 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANTHONY BONANNO (DIRECTOR) |
Mailing Address: | 61 West Ave Wellsboro |
State: | PA US |
Postal Code: | 169011352 |
Phone Number: | 5707230928 |
Fax Number: | 5707230931 |
NPI Enumeration Date: | 08/25/2014 |
NPI Last Update Date: | 08/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |