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NPI Code Detail

MEDICARE: CHESAPEAKE BAY OPTICIANS,INC

MEDICARE: CHESAPEAKE BAY OPTICIANS,INC
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
1332H00000XEyewear Supplier04275834MD

General Provider Information

NPI Number : 1164673281
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESAPEAKE BAY OPTICIANS,INC
Provider Business Mailing Address
First Line : 3819 HARBOR RD UNIT 104
Second Line :
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-3110
Country : US
Telephone Number : 301-855-7383
Fax Number :
Provider Business Practice Location Address
First Line : 3819 HARBOR RD UNIT 104
Second Line :
City : CHESAPEAKE BEACH
State : MD
Zip : 20732-3110
Country : US
Telephone Number : 301-855-7383
Fax Number :
Authorized Official
Title or Position : OPTICIAN/OWNER
Name : MR. DENNIS A HERBER
Credential :
Telephone Number : 301-855-7383
Provider Enumeration Date : 10/07/2008
Last Update Date : 10/07/2008

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Directions to “CHESAPEAKE BAY OPTICIANS,INC ” Practice Location

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