Organization Active NPI

Independence Corporation

  • Optometrist
  • Hazle Township, PA
National Provider Identifier
1508008376
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
INDEPENDENCE CORPORATION
Practice address
578 Susquehanna Blvd
Hazle Township, PA 18202-3233
Phone
(570) 459-2200
Fax
(570) 459-8690
NPI assigned
Mar 25, 2009
Organization subpart
Yes
Parent organization
INDEPENDENCE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

578 Susquehanna Blvd
Hazle Township, PA 18202-3233

Mailing address

4119 Mauch Chunk Rd # C
Coplay, PA 18037-2106
Phone (610) 799-2020

Other identifiers 1

IdentifierTypeStateIssuer
0018518950002MedicaidPA

Other names 1

  • EYELAND OPTICAL INC Doing business as

National Provider Directory

National Provider Directory
Part of
Independence Corporation

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": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1508008376",
    "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": "578 SUSQUEHANNA BLVD",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182023233",
            "telephone_number": "570-459-2200",
            "fax_number": "570-459-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENCE CORPORATION",
        "enumeration_date": "2009-03-25",
        "last_updated": "2013-12-06",
        "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"
        }
    ]
}

Other providers in Hazle Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.