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NPI Code Detail

MEDICARE: EYE CARE CENTER OF LEESBURG

MEDICARE: EYE CARE CENTER OF LEESBURG
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
1152W00000XOptometrist0618000421VA

General Provider Information

NPI Number : 1588746226
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE CARE CENTER OF LEESBURG
Provider Business Mailing Address
First Line : 12 FAIRFAX ST SE
Second Line :
City : LEESBURG
State : VA
Zip : 20175-3616
Country : US
Telephone Number : 703-777-1299
Fax Number : 703-777-5645
Provider Business Practice Location Address
First Line : 12 FAIRFAX ST SE
Second Line :
City : LEESBURG
State : VA
Zip : 20175-3616
Country : US
Telephone Number : 703-777-1299
Fax Number : 703-777-5645
Authorized Official
Title or Position : PRESIDENT
Name : DR. GREG W MCGREW
Credential : OD
Telephone Number : 703-777-1299
Provider Enumeration Date : 10/20/2006
Last Update Date : 02/08/2012

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Directions to “EYE CARE CENTER OF LEESBURG ” Practice Location

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