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General NPI Number Information
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NPI Number | 1720004203
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Entity Type | Organization
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Legal Business Name | DEPENDABLE EYE CARE INC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 916 WASHINGTON AVE
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City | CHESTERTOWN
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State | MD
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Zip | 21620
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Country | US
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Telephone | 410-778-0094
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Fax | 410-778-3454
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Provider Business Mailing Address
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Address Line | PO BOX 612 916 WASHINGTON AVE
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City | CHESTERTOWN
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State | MD
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Zip | 21620
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Country | US
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Telephone | 410-778-0094
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Fax | 410-778-3454
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Authorized Official
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Title or Position | OWNER VICE PRESIDENT
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Name | MS. LINDA R KEATING
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Credential | OPTICIAN
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Telephone | 410-778-0094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14210276TRADER
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License Number State | MD
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