Healthcare Provider Details

I. General information

NPI: 1164423869
Provider Name (Legal Business Name): EPHRATA FAMILY EYE CARE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 05/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E MAIN ST
EPHRATA PA
17522-2710
US

IV. Provider business mailing address

PO BOX 699 101 E MAIN STREET
EPHRATA PA
17522-0699
US

V. Phone/Fax

Practice location:
  • Phone: 717-738-2488
  • Fax: 717-721-9088
Mailing address:
  • Phone: 717-738-2488
  • Fax: 717-721-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000376 OEG000476
License Number StatePA

VIII. Authorized Official

Name: DR. RONALD J BENSING
Title or Position: PARTNER
Credential: OD
Phone: 717-738-2488