Organization
LAUREL EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLYNN COOK (ADMINISTRATOR)
(814) 849-8344
Entity
Organization
Contact information
Practice address
215 S BROAD ST # 217, GROVE CITY, PA 16127-1503
(724) 458-4840
Mailing address
215 S BROAD ST # 217, GROVE CITY, PA 16127-1503
(724) 458-4840
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF3515
RAILROAD MEDICARE GROUP #
—
Enumeration date
08/27/2006
Last updated
03/26/2013
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