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General NPI Number Information
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NPI Number | 1396395166
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Entity Type | Organization
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Legal Business Name | FARR OUT EYECARE LLC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 820 MARKET ST
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City | WESTMINSTER
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State | MD
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Zip | 21157-6114
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Country | US
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Telephone | 410-848-2507
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 WESTERN CHAPEL RD
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City | WESTMINSTER
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State | MD
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Zip | 21157-6744
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Country | US
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Telephone | 301-503-2279
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DAWN MARIE FARR
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Credential | OD
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Telephone | 301-503-2279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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