Organization Name: | REDOVAN OPTICAL |
NPI Number: | 1306929310 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWARD G REDOVAN (OWNER) |
Mailing Address: | 708 N Jefferson St New Castle |
State: | PA US |
Postal Code: | 161012178 |
Phone Number: | 7246587463 |
Fax Number: | 7246544499 |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 002512 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |