Healthcare Provider Details

I. General information

NPI: 1124642343
Provider Name (Legal Business Name): TRI-CENTURY EYE CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 11/16/2021
Certification Date: 10/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 SECOND STREET PIKE
SOUTHAMPTON PA
18966-3812
US

IV. Provider business mailing address

216 MILL ST
BRISTOL PA
19007-4809
US

V. Phone/Fax

Practice location:
  • Phone: 215-355-4428
  • Fax: 215-788-3504
Mailing address:
  • Phone: 215-781-6793
  • Fax: 215-788-3504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BARBARA ANN KILLMER
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 216-781-2020