Formica Optical

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FORMICA OPTICAL

Practice address

110 Revco Rd
Somerset, PA 15501-7726

Phone

(814) 443-6508

Fax

(814) 443-0590

NPI assigned

Oct 19, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles A Formica

Title

Owner

Phone

(814) 443-6508

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083603385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 REVCO RD",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155017726",
            "telephone_number": "814-443-6508",
            "fax_number": "814-443-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 REVCO RD",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155017726",
            "telephone_number": "814-443-6508",
            "fax_number": "814-443-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMICA OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORMICA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-443-6508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012176490001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarret Firestone, DC
• Kristi Fisher
• Alisa Blake Flowers, RN
• Christie Fochtman
• Heather M Foor, M.S
• Elise M Franciscus, MOT-OTR/L
• Harvey H Frankel, DMD
• Karen W Frantz, LSW
• Amy Jean Fritz, RPH
• Susan Frombach, RN

• Durable Medical Equipment & Medical Supplies in Somerset, PA
• Providers in Somerset, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.