Provider Demographics
NPI:1447319355
Name:VISION MAX
Entity type:Organization
Organization Name:VISION MAX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KRINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-374-8981
Mailing Address - Street 1:1026 N SUSQUEHANNA TRAIL
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870
Mailing Address - Country:US
Mailing Address - Phone:570-374-8981
Mailing Address - Fax:
Practice Address - Street 1:1026 N SUSQUEHANNA TRAIL
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870
Practice Address - Country:US
Practice Address - Phone:570-374-8981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOB008703152W00000X
PAOEG000436152W00000X
PA6000006789156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAVI 1811852OtherCLARITY VISION
PA23082OtherNVA
PA52677OtherDAVIS VISION
PA52677OtherDAVIS VISION