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NPI Code Detail

MEDICARE: COLONIAL FAMILY EYECARE, LLC

MEDICARE: COLONIAL FAMILY EYECARE, LLC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1437394442
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLONIAL FAMILY EYECARE, LLC
Provider Business Mailing Address
First Line : 301 N LEWIS RD
Second Line : #165
City : ROYERSFORD
State : PA
Zip : 19468-1531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N LEWIS RD
Second Line : #165
City : ROYERSFORD
State : PA
Zip : 19468-1531
Country : US
Telephone Number : 610-948-7000
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KEVIN REHAK
Credential : OD
Telephone Number : 610-948-7000
Provider Enumeration Date : 12/04/2008
Last Update Date : 04/19/2010

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Directions to “COLONIAL FAMILY EYECARE, LLC ” Practice Location

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