Bouquet Mulligan Eye Professionals LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OEG000036 Issued in PA

Legal business name

BOUQUET MULLIGAN EYE PROFESSIONALS LTD

Practice address

1676 S Market St
Elizabethtown, PA 17022-2853

Phone

(717) 272-0581

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gregory M Bracale

Title

Admininstrator

Phone

(717) 272-0581

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bouquet Mulligan Eye Professionals LTD

  • Eyewear Supplier
  • Cleona, PA
  • NPI 1164503934

  5991918385

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Bouquet Mulligan Eye Professionals LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Bouquet Mulligan Eye Professionals LTD

  • Eyewear Supplier
  • Cleona, PA
  • NPI 1164503934
  NPD tax ID
• Bouquet Mulligan Eye Professionals LTD

  • Eyewear Supplier
  • Elizabethtown, PA
  • NPI 1780011999
  NPD tax ID

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616112000000",
    "number": "1124239124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1676 S MARKET ST",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222853",
            "telephone_number": "717-272-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1676 S MARKET ST",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170222853",
            "telephone_number": "717-272-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUQUET MULLIGAN EYE PROFESSIONALS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A",
        "authorized_official_last_name": "BRACALE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMININSTRATOR",
        "authorized_official_telephone_number": "717-272-0581",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PA",
            "license": "OEG000036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Mackenzie Boots
• William Joseph Borowski, DDS
• Hillary Shearer Bossert-Davis, LCSW
• Bouquet Mulligan Demaio Eye Professionals
• Bouquet Mulligan Demaio Eye Professionals
• Bouquet Mulligan Eye Professionals LTD
• Kimberly Brooke Rivera Bourke, PA-C
• Christopher David Brabazon, DO
• Breakthrough Music Therapy LLC
• Zachary Bricker, CRNP

• All providers in Elizabethtown, PA
• Eyewear Supplier in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.