MEDICARE: CATARACT AND PRIMARY EYE CARE SERVICE, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician		PA

General Provider Information

NPI Number	:	1417991720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATARACT AND PRIMARY EYE CARE SERVICE, LP

Provider Business Mailing Address
First Line	:	840 WALNUT ST
Second Line	:	SUITE 1250
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5109
Country	:	US
Telephone Number	:	215-928-3900
Fax Number	:	215-928-1772

Provider Business Practice Location Address
First Line	:	840 WALNUT ST
Second Line	:	SUITE 1250
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5109
Country	:	US
Telephone Number	:	215-928-3900
Fax Number	:	215-928-1772

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. COLLEEN M TRINDLE
Credential	:
Telephone Number	:	215-928-3470

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	03/16/2018

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