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NPI Code Detail

MEDICARE: PHILIP E. GLANVILLE O.D.,INC.

MEDICARE: PHILIP E. GLANVILLE O.D.,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
1332H00000XEyewear Supplier3119OH

General Provider Information

NPI Number : 1528230125
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILIP E. GLANVILLE O.D.,INC.
Provider Business Mailing Address
First Line : 6785 WALLINGS RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3024
Country : US
Telephone Number : 440-237-9120
Fax Number : 440-237-9124
Provider Business Practice Location Address
First Line : 6785 WALLINGS RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3024
Country : US
Telephone Number : 440-237-9120
Fax Number : 440-237-9124
Authorized Official
Title or Position : OWNER
Name : DR. PHILIP EDWARDS GLANVILLE
Credential : O.D.
Telephone Number : 440-237-9120
Provider Enumeration Date : 03/24/2008
Last Update Date : 05/05/2008

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Directions to “PHILIP E. GLANVILLE O.D.,INC. ” Practice Location

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