Healthcare Provider Details

I. General information

NPI: 1801902226
Provider Name (Legal Business Name): USA OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 LOUCKS RD SUITE 653
YORK PA
17408-4609
US

IV. Provider business mailing address

1800 LOUCKS RD SUITE 653
YORK PA
17408-4609
US

V. Phone/Fax

Practice location:
  • Phone: 717-764-8705
  • Fax: 717-767-5680
Mailing address:
  • Phone: 717-764-8705
  • Fax: 717-767-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. G K KRABEL
Title or Position: INSURANCE
Credential:
Phone: 717-764-8705