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General NPI Number Information
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NPI Number | 1053562397
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Entity Type | Organization
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Legal Business Name | EASTON OPTICAL, LLC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 210 MARLBORO AVE STE 31
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City | EASTON
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State | MD
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Zip | 21601-2767
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Country | US
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Telephone | 410-822-3937
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Fax | 410-822-2652
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Provider Business Mailing Address
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Address Line | 210 MARLBORO AVE STE 31
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City | EASTON
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State | MD
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Zip | 21601-2767
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Country | US
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Telephone | 410-822-3937
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Fax | 410-822-2652
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALAN SCOTT BISHOP
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Credential | O.D.
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Telephone | 410-822-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | MD
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