Independence Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

INDEPENDENCE CORPORATION

Practice address

3090 N Susquehanna Trail Rd
Shamokin Dam, PA 17876

Phone

(570) 743-3937

Fax

(570) 743-3005

NPI assigned

Mar 30, 2009

Organization subpart

Yes

Parent organization

INDEPENDENCE CORPORATIONAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 1

• EYELAND OPTICAL INC Doing business as

Part of

Independence Corporation

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.

• Independence Corporation

  • Optometrist
  • Whitehall, PA
  • NPI 1972549657
  NPPES parent name

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1407098908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 MAUCH CHUNK RD # C",
            "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": "3090 N SUSQUEHANNA TRAIL RD",
            "city": "SHAMOKIN DAM",
            "state": "PA",
            "postal_code": "17876",
            "telephone_number": "570-743-3937",
            "fax_number": "570-743-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENCE CORPORATION",
        "enumeration_date": "2009-03-30",
        "last_updated": "2012-03-06",
        "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": "193400000X SINGLE SPECIALTY  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"
        }
    ]
}

• Kelsey Grow
• Keri A Hain
• Bryce Herb
• Jessica Hoover
• Jennifer Roxann Inch
• Erica Paige Jackson, PHARMD
• Zahirah Jordan
• Marissa Danielle Keller, BCBA
• Keystone Center of Integrated Wellness, LLC
• Keystone Oral Surgery Associates PC

• Optometrist in Shamokin Dam, PA
• Providers in Shamokin Dam, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.