Healthcare Provider Details

I. General information

NPI: 1275678765
Provider Name (Legal Business Name): JOEL H. MCGAHEN, OD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 PHOENIX DR
CHAMBERSBURG PA
17201-4537
US

IV. Provider business mailing address

422 PHOENIX DR
CHAMBERSBURG PA
17201-4537
US

V. Phone/Fax

Practice location:
  • Phone: 717-264-4012
  • Fax: 717-264-5745
Mailing address:
  • Phone: 717-264-4012
  • Fax: 717-264-5745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000370
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberOEG000370
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOEG000370
License Number StatePA

VIII. Authorized Official

Name: DR. JOEL HOWARD MCGAHEN
Title or Position: PRESIDENT
Credential: OD
Phone: 717-264-4012