Organization
EYE ASSOCIATES OF OLATHE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT A PENNIPEDE OD (OWNER)
(913) 339-9090
Entity
Organization
Contact information
Practice address
15249 W 135TH ST, OLATHE, KS 66062
(913) 780-9696
(913) 780-4975
Mailing address
10120 W 119TH ST, OVERLAND PARK, KS 66213
(913) 339-9090
(913) 339-6417
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26236016
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
01
—
738029
BLUE CROSS BLUE SHIELD OF KANSAS
KS
01
—
DB4989
RR MEDICARE
KS
Enumeration date
12/15/2006
Last updated
04/09/2009
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