Healthcare Provider Details
I. General information
NPI: 1174608632
Provider Name (Legal Business Name): HARRINGTON EYE CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2006
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
203 SHAW AVE
HARRINGTON DE
19952-1220
US
IV. Provider business mailing address
203 SHAW AVE
HARRINGTON DE
19952-1220
US
V. Phone/Fax
- Phone: 302-398-8404
- Fax: 302-398-8990
- Phone: 302-398-8404
- Fax: 302-398-8990
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
QUILLIN
Title or Position: PHYSICIAN
Credential: OD
Phone: 302-398-8404