Healthcare Provider Details

I. General information

NPI: 1356569586
Provider Name (Legal Business Name): BROWN OPTICAL COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 WALNUT BOTTOM RD
CARLISLE PA
17015
US

IV. Provider business mailing address

PO BOX 669
CARLISLE PA
17013-0669
US

V. Phone/Fax

Practice location:
  • Phone: 717-249-5436
  • Fax:
Mailing address:
  • Phone: 717-249-5436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number6000000004
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberD00188
License Number StatePA

VIII. Authorized Official

Name: MR. CARL WALTER HEINEMAN
Title or Position: PRESIDENT
Credential:
Phone: 717-249-5436