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General NPI Number Information
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NPI Number | 1326460221
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Entity Type | Organization
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Legal Business Name | MT. HOOD EYE CARE CORPORATION
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Dates
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Enumeration Date | 01/11/2014
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 36840 INDUSTRIAL WAY STE D
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City | SANDY
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State | OR
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Zip | 97055-9254
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Country | US
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Telephone | 503-484-8663
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Fax |
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Provider Business Mailing Address
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Address Line | 36840 INDUSTRIAL WAY STE D
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City | SANDY
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State | OR
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Zip | 97055-9254
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Country | US
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Telephone | 503-484-8663
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANTHONY JAMES TURIN
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Credential | O.D. F.A.A.O.
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Telephone | 503-482-0475
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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 |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3371ATI
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License Number State | OR
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