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NPI Code Detail

MEDICARE: SPECTERA

MEDICARE: SPECTERA
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 Supplier

General Provider Information

NPI Number : 1568488690
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECTERA
Provider Business Mailing Address
First Line : 2811 LORD BALTIMORE DR
Second Line :
City : BALTIMORE
State : MD
Zip : 21244
Country : US
Telephone Number : 443-316-2101
Fax Number : 410-265-6068
Provider Business Practice Location Address
First Line : 2183 SOUTH TAYLOR ROAD
Second Line : UNITED OPTICAL
City : UNIVERSITY HEIGHTS
State : OH
Zip : 44118-3012
Country : US
Telephone Number : 216-932-9543
Fax Number : 216-932-9651
Authorized Official
Title or Position : VICE PRESIDENT DIRECTOR OF OPTICAL
Name : THOMAS A HEETER
Credential :
Telephone Number : 443-316-2061
Provider Enumeration Date : 07/14/2006
Last Update Date : 08/22/2020

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Directions to “SPECTERA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.