Cpmoptometry LLC
Organization Active NPI Point of Service · Mt Pocono, PA
NPI 1578039574 · NPPES record last updated Mar 14, 2019
Key facts
- NPI
- 1578039574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Point of Service 305S00000X
- Legal business name
- CPMOPTOMETRY LLC
- Practice address
- Walmart Vision
3271 PA 940
Mt Pocono, PA 17325 - Phone
- (570) 895-4791
- Fax
- (570) 895-4793
- NPI assigned
- Oct 17, 2018
- Organization subpart
- No
Authorized official
- Name
- Charles Morgan
- Title
- Optometrist
- Phone
- (570) 895-4791
Practitioners 1
-
Charles Patrick Morgan, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190315000804 | PA | Part B Supplier - Clinic/Group Practice | 9133469828 |
Receives reassigned benefits from 1 practitioner Practice locations: Mount Pocono, PA |
National Provider Directory
Locations
3271 Route 940
Mount Pocono, PA 18344
Phone (570) 895-4781
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Point of Service | 305S00000X | Yes |
Addresses
Primary practice location
Walmart Vision
3271 PA 940
Mt Pocono, PA 17325
Mailing address
Walmart Vision
3271 Route 940
Mt Pocono, PA 18344
Phone (570) 895-4791
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11729544 | Other | WY | CAHQ |
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- Kenneth Michael Czar
- Cassandra Daniels
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All providers in Mt Pocono, PA · Point of Service in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2019. 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.