Healthcare Provider Details

I. General information

NPI: 1073991519
Provider Name (Legal Business Name): ALLIED VISION CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2015
Last Update Date: 05/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9713 HEDIN DR
SILVER SPRING MD
20903-1805
US

IV. Provider business mailing address

9713 HEDIN DR
SILVER SPRING MD
20903-1805
US

V. Phone/Fax

Practice location:
  • Phone: 301-445-3400
  • Fax: 301-445-3401
Mailing address:
  • Phone: 301-445-3400
  • Fax: 301-445-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNS9912016
License Number StateMD

VIII. Authorized Official

Name: MR. DAVID W DONGO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: CFE
Phone: 202-751-9020