Organization
INDEPENDENCE CORPORATION
Active
Parent organization
INDEPENDENCE CORPORATION
Other names
EYELAND OPTICAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE CORPORATION
Authorized official
LISA PAUSINGER (INSURANCE A/R)
(610) 799-2020
Entity
Organization
Contact information
Practice address
1545 N 9TH ST, SUITE 110, STROUDSBURG, PA 18360-9266
(570) 424-9988
(570) 424-9697
Mailing address
4119 MAUCH CHUNK RD # C, COPLAY, PA 18037-2106
(610) 799-2020
(610) 799-4399
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018518950002
—
PA
Enumeration date
03/25/2009
Last updated
12/15/2011
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