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NPI Code Detail

MEDICARE: JUDGE AND TOOLE EYE CARE

MEDICARE: JUDGE AND TOOLE EYE CARE
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
14937810001OTHERPANHIC CORP DME MAC JUR A

General Provider Information

NPI Number : 1487684130
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUDGE AND TOOLE EYE CARE
Provider Business Mailing Address
First Line : 500 SCOTT ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-5616
Country : US
Telephone Number : 570-704-0300
Fax Number : 570-704-0309
Provider Business Practice Location Address
First Line : 500 SCOTT ST
Second Line :
City : WILKES BARRE
State : PA
Zip : 18702-5616
Country : US
Telephone Number : 570-704-0300
Fax Number : 570-704-0309
Authorized Official
Title or Position : OWNER
Name : LISA TOOLE
Credential : OD
Telephone Number : 570-704-0300
Provider Enumeration Date : 07/04/2006
Last Update Date : 06/24/2008

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Directions to “JUDGE AND TOOLE EYE CARE ” Practice Location

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