Organization
CAROL'S SPECIALTY SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL N. MAURER (OWNER)
(717) 273-5055
Entity
Organization
Contact information
Practice address
809 E EVERGREEN RD, LEBANON, PA 17042-7928
(717) 273-5055
Mailing address
809 E EVERGREEN RD, LEBANON, PA 17042-7928
(717) 273-5055
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
600003485
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000212306
HIGHMARK B S
PA
01
—
50017682
BAPITAL BLUE CROSS
PA
Enumeration date
01/30/2008
Last updated
03/10/2008
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