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EYE RESTORATION CLINIC INC.

Eye and Vision Services Providers Technician/Technologist Ocularist

Provider NPI: 1174668693

Organization Information:
Organization Name:  EYE RESTORATION CLINIC INC.
Organization is not Subpart
Authorized Official:  THOMAS  MEAKEM  OWNER  301-599-6300

Practice Location:
9450 PENNSYLVANIA AVE SUITE #15 UPPER MARLBORO, MD 20772-3665 US
Tel: 301-599-6300  Fax: 301-599-0578

Business Mailing Address:
9450 PENNSYLVANIA AVE SUITE #15 UPPER MARLBORO, MD 20772-3665 US
Tel: 301-599-6300  Fax: 301-599-0578

NPI Information:
NPI: 1174668693
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N156FX1700XEye and Vision Services Providers
Technician/Technologist
Ocularist
MD3853
Y332BC3200XSuppliers
Durable Medical Equipment & Medical Supplies
MD

Other Provider Identifiers:

IssuerNumberStateType
468228900MD05
KAISER PERMANANTE30877MD01
MEDICARE RR406540466DC01
023053600DC05



American Medical Association 2012 taxonomy code information

Code: 332BC3200X

Type:

Classification:



Definition:



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