Cowburn and Keppich LLC
Organization Active NPI Optometrist · Vandergrift, PA
NPI 1275925349 · NPPES record last updated Feb 26, 2015
Key facts
- NPI
- 1275925349
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- COWBURN AND KEPPICH LLC
- Practice address
- 135 Columbia Ave
Vandergrift, PA 15690-1101 - Phone
- (724) 568-2661
- Fax
- (724) 567-2340
- NPI assigned
- Feb 26, 2015
- Organization subpart
- No
Authorized official
- Name
- Ryan William Cowburn, O.D.
- Title
- Optometrist/Owner
- Phone
- (724) 568-2661
Practitioners 5
-
Todd Michael Keppich, O.D.
-
Ryan William Cowburn, O.D.
-
Kacey Beth Cowburn, SLP
-
Joseph J Raglani, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150416000110 | PA | Part B Supplier - Clinic/Group Practice | 0547588972 |
Receives reassigned benefits from 3 practitioners Practice locations: Vandergrift, PA |
National Provider Directory
Locations
135 Columbia Ave
Vandergrift, PA 15690
Phone (724) 568-2661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
135 Columbia Ave
Vandergrift, PA 15690-1101
Mailing address
135 Columbia Ave
Vandergrift, PA 15690-1101
Phone (724) 568-2661
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All providers in Vandergrift, PA · Optometrist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.