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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Vandergrift, PA

All providers in Vandergrift, PA · Optometrist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.