MEDICARE: GLAUCOMA PLUS EYE CARE, 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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1215744743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLAUCOMA PLUS EYE CARE, LLC

Provider Business Mailing Address
First Line	:	5550 STERRETT PL STE 312
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2628
Country	:	US
Telephone Number	:	410-715-2212
Fax Number	:	410-715-2214

Provider Business Practice Location Address
First Line	:	5550 STERRETT PL STE 312
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2628
Country	:	US
Telephone Number	:	410-715-2212
Fax Number	:	410-715-2214

Authorized Official
Title or Position	:	OWNER
Name	:	ANSHU SINHA
Credential	:
Telephone Number	:	410-715-2212

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	12/17/2024

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