MEDICARE: DONALD ROBERT PREUHS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician

General Provider Information

NPI Number	:	1104880954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD ROBERT PREUHS

Provider Business Mailing Address
First Line	:	1239 E WASHINGTON ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-4485
Country	:	US
Telephone Number	:	724-652-7283
Fax Number	:

Provider Business Practice Location Address
First Line	:	1239 E WASHINGTON ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-4485
Country	:	US
Telephone Number	:	724-652-7283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	01/14/2011

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