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NPI Code Detail

MEDICARE: BAINBRIDGE EYE CARE ASSOCIATES, INC.

MEDICARE: BAINBRIDGE EYE CARE ASSOCIATES, INC.
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
1152WC0802XCorneal and Contact Management OptometristOEG000596PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11618698OTHERPAPERSONAL CHOISE
21618698OTHERPAHIGHMARK BLUE SHIELD
31618698OTHERPAPREMIER BLUE SHIELD
41618698OTHERPAINDEPENDENCE BLUE CROSS
52658183OTHERPAAETAN
62301209000OTHERPAKEYSTONE HEALTHCARE EAST

General Provider Information

NPI Number : 1265515746
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAINBRIDGE EYE CARE ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 1255 WEST CHESTER PIKE
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-5646
Country : US
Telephone Number : 610-692-2212
Fax Number : 610-692-2235
Provider Business Practice Location Address
First Line : 1255 WEST CHESTER PIKE
Second Line :
City : WEST CHESTER
State : PA
Zip : 19382-5646
Country : US
Telephone Number : 610-692-2212
Fax Number : 610-692-2235
Authorized Official
Title or Position : PRESIDENT
Name : DR. TODD TERRY BAINBRIDGE
Credential : O.D.
Telephone Number : 610-692-2212
Provider Enumeration Date : 10/20/2006
Last Update Date : 02/21/2008

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