Provider Demographics
NPI:1861430027
Name:WEAVER EYE ASSOCIATES LLC
Entity type:Organization
Organization Name:WEAVER EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-848-4654
Mailing Address - Street 1:2155 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-4900
Mailing Address - Country:US
Mailing Address - Phone:717-848-4654
Mailing Address - Fax:717-848-2188
Practice Address - Street 1:2155 WHITE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-4900
Practice Address - Country:US
Practice Address - Phone:717-848-4654
Practice Address - Fax:717-848-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0165770003Medicare NSC
PA0165770003Medicare UPIN