Active NPI
Independence Corp
Doing business as eyeland optical inc
- Optometrist
- Coplay, PA
National Provider Identifier
1235371683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- INDEPENDENCE CORP
- Doing business as
- eyeland optical inc
- Practice address
- 4119C Mauch Chunk Rd
Coplay, PA 18037-2106 - Phone
- (610) 799-2020
- Fax
- (610) 799-4399
- NPI assigned
- Apr 1, 2009
- Last updated
- Apr 1, 2009
- Organization subpart
- Yes
- Parent organization
- INDEPENDENCE CORP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Pausinger
- Title
- Ins Ar
- Phone
- (610) 799-2020
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
4119C Mauch Chunk Rd
Coplay, PA 18037-2106
Mailing address
4119C Mauch Chunk Rd
Coplay, PA 18037-2106
Phone (610) 799-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018518950002 | Medicaid | PA |
Other names 1
- eyeland optical inc
National Provider Directory
National Provider Directory- Tax ID family
- Independence Corp
- Part of
- Independence Corp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
4119C Mauch Chunk Rd
Coplay, PA 18037
Phone (610) 799-2020
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1238544000000",
"number": "1235371683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4119C MAUCH CHUNK RD",
"city": "COPLAY",
"state": "PA",
"postal_code": "180372106",
"telephone_number": "610-799-2020",
"fax_number": "610-799-4399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4119C MAUCH CHUNK RD",
"city": "COPLAY",
"state": "PA",
"postal_code": "180372106",
"telephone_number": "610-799-2020",
"fax_number": "610-799-4399"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INDEPENDENCE CORP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "INDEPENDENCE CORP",
"enumeration_date": "2009-04-01",
"last_updated": "2009-04-01",
"status": "A",
"authorized_official_last_name": "PAUSINGER",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "INS AR",
"authorized_official_telephone_number": "610-799-2020"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018518950002",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "eyeland optical inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Coplay, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.