Healthcare Provider Details

I. General information

NPI: 1194763128
Provider Name (Legal Business Name): GLOBAL VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2429 CLEANLEIGH DR
PARKVILLE MD
21234-6808
US

IV. Provider business mailing address

2429 CLEANLEIGH DR
PARKVILLE MD
21234-6808
US

V. Phone/Fax

Practice location:
  • Phone: 410-663-8393
  • Fax: 410-663-8394
Mailing address:
  • Phone: 410-663-8393
  • Fax: 410-663-8394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number03181553
License Number StateMD

VIII. Authorized Official

Name: KEVIN D SMITH
Title or Position: MANAGER
Credential:
Phone: 410-663-8393