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General NPI Number Information
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NPI Number | 1689882151
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Entity Type | Organization
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Legal Business Name | CHENANGO VISION CENTER, INC.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 04/07/2008
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Provider Practice Location Address
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Address Line | 5811 CO. RT. 32
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City | NORWICH
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State | NY
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Zip | 13815-3904
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Country | US
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Telephone | 607-336-2020
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Fax | 607-336-1003
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Provider Business Mailing Address
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Address Line | PO BOX 904 5811 CO. RT. 32
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City | NORWICH
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State | NY
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Zip | 13815-3904
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Country | US
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Telephone | 607-336-2020
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Fax | 607-336-1003
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN G BIRDSALL
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Credential |
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Telephone | 607-336-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV005032
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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