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General NPI Number Information
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NPI Number | 1962641969
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Entity Type | Organization
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Legal Business Name | EYEMAXX, LLC
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 1367 WILMINGTON PIKE
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City | WEST CHESTER
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State | PA
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Zip | 19382-8266
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Country | US
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Telephone | 610-399-3700
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Fax | 610-399-9753
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Provider Business Mailing Address
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Address Line | 1367 WILMINGTON PIKE
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City | WEST CHESTER
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State | PA
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Zip | 19382-8266
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Country | US
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Telephone | 610-399-3700
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Fax | 610-399-9753
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. SANDRA BWINT
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Credential | O.D.
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Telephone | 610-399-3700
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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 | OE006708P
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License Number State | PA
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