Healthcare Provider Details

I. General information

NPI: 1134623671
Provider Name (Legal Business Name): PRO-SPECS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 LANCASTER AVE
BERWYN PA
19312-1297
US

IV. Provider business mailing address

1175 LANCASTER AVE
BERWYN PA
19312-1297
US

V. Phone/Fax

Practice location:
  • Phone: 610-384-9100
  • Fax: 610-384-3937
Mailing address:
  • Phone: 610-384-9100
  • Fax: 610-384-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DREW R CHRONISTER
Title or Position: SECRETARY
Credential: M.D.
Phone: 610-384-9100