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NPI Code Detail

MEDICARE: TCTF LLC

MEDICARE: TCTF LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician

General Provider Information

NPI Number : 1518135789
Entity Type Code : Organization
Provider Name (Legal Business Name) : TCTF LLC
Provider Business Mailing Address
First Line : 10300 LITTLE PATUXENT PKWY
Second Line : STE. 2870
City : COLUMBIA
State : MD
Zip : 21044-3341
Country : US
Telephone Number : 410-884-6500
Fax Number : 410-884-0873
Provider Business Practice Location Address
First Line : 10300 LITTLE PATUXENT PKWY
Second Line : STE. 2870
City : COLUMBIA
State : MD
Zip : 21044-3341
Country : US
Telephone Number : 410-884-6500
Fax Number : 410-884-0873
Authorized Official
Title or Position : C.O.O.
Name : MR. TIMOTHY C. COOKE
Credential :
Telephone Number : 443-848-6498
Provider Enumeration Date : 02/11/2008
Last Update Date : 02/11/2008

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Directions to “TCTF LLC ” Practice Location

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