Organization
PREMIER EYE CARE GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEOFFREY JOHN BRENT MD (PRESIDENT)
(717) 232-2245
Entity
Organization
Contact information
Practice address
3903 HARTZDALE DR, CAMP HILL, PA 17011
(717) 761-3077
(717) 761-1186
Mailing address
92 TUSCARORA ST, HARRISBURG, PA 17104-1667
(717) 232-0843
(717) 232-2215
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OEG000093
PA
207W00000X
Ophthalmology Physician
Primary
MD020133E
PA
332B00000X
Durable Medical Equipment & Medical Supplies
6000004226
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01471368
—
PA
05
—
01823136
—
PA
01
—
2276000
CAPITAL BC
PA
01
—
747187
HIGHMARK BS
PA
01
—
756393
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/15/2005
Last updated
08/06/2018
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