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General NPI Number Information
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NPI Number | 1063859734
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Entity Type | Organization
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Legal Business Name | CAPITOL EYES INC.
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 1201 F ST NW
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City | WASHINGTON
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State | DC
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Zip | 20004-1217
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Country | US
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Telephone | 202-347-9260
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Fax | 202-347-9264
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Provider Business Mailing Address
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Address Line | 1201 F ST NW
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City | WASHINGTON
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State | DC
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Zip | 20004-1217
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Country | US
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Telephone | 202-347-9260
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Fax | 202-347-9264
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Authorized Official
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Title or Position | OWNNER
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Name | DR. GLENN PATRICK ALLOUCHE
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Credential | O.D.
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Telephone | 202-347-9260
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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 | 70170857
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License Number State | DC
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