Healthcare Provider Details

I. General information

NPI: 1366733933
Provider Name (Legal Business Name): BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 RIVER AVE
WILLIAMSPORT PA
17701-3722
US

IV. Provider business mailing address

88 HARDEES DR
MIFFLINBURG PA
17844-7062
US

V. Phone/Fax

Practice location:
  • Phone: 570-326-8070
  • Fax: 570-524-5279
Mailing address:
  • Phone: 866-995-3937
  • Fax: 570-326-0396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: SHELLEY RINE
Title or Position: VICE PRESIDENT
Credential:
Phone: 570-966-5582