Healthcare Provider Details

I. General information

NPI: 1730359837
Provider Name (Legal Business Name): MARGARET A. SHIRK O.D. & ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2514 RIDGE RD
ELVERSON PA
19520-9017
US

IV. Provider business mailing address

2514 RIDGE RD
ELVERSON PA
19520-9017
US

V. Phone/Fax

Practice location:
  • Phone: 610-913-0126
  • Fax: 610-913-0139
Mailing address:
  • Phone: 610-913-0126
  • Fax: 610-913-0139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001294
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOEG001294
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOEG001294
License Number StatePA

VIII. Authorized Official

Name: DR. MARGARET A. SHIRK
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 610-212-2433