Organization
INDEPENDENCE CORPORATION
Active
Parent organization
INDEPENDENCE CORPORATION
Other names
EYELAND OPTICAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE CORPORATION
Authorized official
LISA PAUSINGER (INSURANCE A/R)
(610) 799-2020
Entity
Organization
Contact information
Practice address
92 BLAKESLEE BOULEVARD DR E, LEHIGHTON, PA 18235-9045
(610) 379-9445
(610) 379-9447
Mailing address
4119C MAUCH CHUNK RD, COPLAY, PA 18037-2106
(610) 799-2020
(610) 799-4399
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018518950002
—
PA
01
—
0830100015
MEDICARE PTAN
PA
Enumeration date
03/25/2009
Last updated
05/31/2012
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