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NPI Code Detail

MEDICARE: GOODMAN EYECARE CENTER, LLC

MEDICARE: GOODMAN EYECARE CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16071190001OTHERDMERC

General Provider Information

NPI Number : 1013072263
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOODMAN EYECARE CENTER, LLC
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-2442
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 3309 FORESTVILLE PL
Second Line :
City : FORESTVILLE
State : MD
Zip : 20747-4409
Country : US
Telephone Number : 301-420-6610
Fax Number : 301-735-0294
Authorized Official
Title or Position : SECRETARY
Name : SUE DOWNES
Credential :
Telephone Number : 703-847-8899
Provider Enumeration Date : 12/27/2006
Last Update Date : 04/28/2025

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Directions to “GOODMAN EYECARE CENTER, LLC ” Practice Location

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