Healthcare Provider Details

I. General information

NPI: 1871596494
Provider Name (Legal Business Name): HAGER OPTICAL, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E BALTIMORE ST
HAGERSTOWN MD
21740-6144
US

IV. Provider business mailing address

251 E BALTIMORE ST
HAGERSTOWN MD
21740-6144
US

V. Phone/Fax

Practice location:
  • Phone: 301-739-7713
  • Fax: 301-739-7717
Mailing address:
  • Phone: 301-739-7713
  • Fax: 301-739-7717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: WILLAM JOSEPH SACHS
Title or Position: PRESIDENT
Credential:
Phone: 301-739-7713