Healthcare Provider Details

I. General information

NPI: 1518520840
Provider Name (Legal Business Name): LITITZ EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E MAIN ST
LITITZ PA
17543-1941
US

IV. Provider business mailing address

686 WARMINSTER LN
LITITZ PA
17543-5006
US

V. Phone/Fax

Practice location:
  • Phone: 585-305-3104
  • Fax:
Mailing address:
  • Phone: 585-305-3104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. SCOTT ALAN CRAWSHAW
Title or Position: OWNER, OPTOMETRIST
Credential: O.D.
Phone: 585-305-3104