Provider Demographics
NPI:1861764888
Name:BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP
Entity type:Organization
Organization Name:BERNSTEIN HILLIKER HARTZELL OPTICAL SHOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:RINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-966-5582
Mailing Address - Street 1:1170 STATE ROUTE 487
Mailing Address - Street 2:
Mailing Address - City:PAXINOS
Mailing Address - State:PA
Mailing Address - Zip Code:17860-7570
Mailing Address - Country:US
Mailing Address - Phone:570-286-1295
Mailing Address - Fax:570-648-3812
Practice Address - Street 1:1170 STATE ROUTE 487
Practice Address - Street 2:
Practice Address - City:PAXINOS
Practice Address - State:PA
Practice Address - Zip Code:17860-7570
Practice Address - Country:US
Practice Address - Phone:570-286-1295
Practice Address - Fax:570-648-3812
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERNSTEIN HILLIKER HARTZELL EYE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-07
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment