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General NPI Number Information
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NPI Number | 1871613083
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Entity Type | Organization
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Legal Business Name | HOMETOWN OPTICS
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2017 S LOUDOUN ST
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City | WINCHESTER
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State | VA
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Zip | 22601-3612
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Country | US
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Telephone | 540-665-0255
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Fax | 540-665-0257
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Provider Business Mailing Address
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Address Line | 2017 S LOUDOUN ST
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City | WINCHESTER
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State | VA
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Zip | 22601-3612
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Country | US
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Telephone | 540-665-0255
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Fax | 540-665-0257
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Authorized Official
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Title or Position | OWNERMANAGER
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Name | DEBORAH E WHITE
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Credential | OPTICIAN
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Telephone | 540-665-0255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101002510
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License Number State | VA
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