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NPI Code Detail

MEDICARE: PENNSYLVANIA COLLEGE OF OPTOMETRY

MEDICARE: PENNSYLVANIA COLLEGE OF OPTOMETRY
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
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134166572
Entity Type Code : Organization
Provider Name (Legal Business Name) : PENNSYLVANIA COLLEGE OF OPTOMETRY
Provider Business Mailing Address
First Line : 1200 W GODFREY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3323
Country : US
Telephone Number : 215-276-6000
Fax Number :
Provider Business Practice Location Address
First Line : 1200 W GODFREY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3323
Country : US
Telephone Number : 215-276-6000
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : GARLAND MCCOY
Credential :
Telephone Number : 215-276-6000
Provider Enumeration Date : 06/02/2006
Last Update Date : 10/09/2024

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Directions to “PENNSYLVANIA COLLEGE OF OPTOMETRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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