Healthcare Provider Details

I. General information

NPI: 1063468395
Provider Name (Legal Business Name): HEIMER EYE CARE ASSOC. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 OLD GATESBURG RD SUITE 300
STATE COLLEGE PA
16803-2276
US

IV. Provider business mailing address

1700 OLD GATESBURG RD SUITE 300
STATE COLLEGE PA
16803-2276
US

V. Phone/Fax

Practice location:
  • Phone: 814-234-1002
  • Fax: 814-234-6251
Mailing address:
  • Phone: 814-234-1002
  • Fax: 814-234-6251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD029202E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY L HEIMER
Title or Position: OWNER
Credential:
Phone: 814-234-1002