Organization Name: | JOHN E ELLIS |
NPI Number: | 1649458308 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN E. ELLIS (OWNER) |
Mailing Address: | 619 E Crawford Ave Connellsville |
State: | PA US |
Postal Code: | 154252102 |
Phone Number: | 7246281370 |
Fax Number: | 7246287314 |
NPI Enumeration Date: | 02/05/2008 |
NPI Last Update Date: | 10/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | OEG001091 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |