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General NPI Number Information
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NPI Number | 1346489465
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Entity Type | Organization
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Legal Business Name | OMEGA OPTICAL, INC.
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 2385 W CHELTENHAM AVE STE 336
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1506
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Country | US
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Telephone | 215-885-1200
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Fax | 215-885-8807
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Provider Business Mailing Address
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Address Line | 2385 W CHELTENHAM AVE STE 336
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1506
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Country | US
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Telephone | 215-885-1200
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Fax | 215-885-8807
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Authorized Official
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Title or Position | MANAGER
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Name | MR. STEVEN DAVIS
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Credential |
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Telephone | 215-885-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State | PA
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