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General NPI Number Information
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NPI Number | 1841426137
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Entity Type | Organization
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Legal Business Name | EYES ON MAIN L.L.C.
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 217 MAIN ST
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City | ANNAPOLIS
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State | MD
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Zip | 21401-2005
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Country | US
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Telephone | 410-268-6246
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Fax | 410-268-6244
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Provider Business Mailing Address
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Address Line | 217 MAIN ST
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City | ANNAPOLIS
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State | MD
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Zip | 21401-2004
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Country | US
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Telephone | 410-268-6246
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Fax | 410-268-2244
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICK LEPSKI
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Credential | OPTICIAN
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Telephone | 410-268-6246
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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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