Organization
BRENT OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY J DEMPSIE (PRESIDENT)
(814) 944-7144
Entity
Organization
Contact information
Practice address
312 ORCHARD AVE, ALTOONA, PA 16602-4066
(814) 944-7144
Mailing address
312 ORCHARD AVE, ALTOONA, PA 16602-4066
(814) 944-7144
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
07105017
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
283248
HIGHMARK
PA
01
—
393534
NVA
PA
Enumeration date
01/23/2007
Last updated
08/22/2020
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