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Organization
PENINSULA EYE CENTER, P.A
Active
Organization
PENINSULA EYE CENTER, P.A
Active
Other names
Peninsula Cataract & Laser Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY JEAN NOCK (BUSINESS OFFICE MANAGER)
(410) 749-9290
Entity
Organization
Contact information
Practice address
101 MILFORD ST, SALISBURY, MD 21804-6952
(410) 749-9290
(410) 543-9087
Mailing address
101 MILFORD ST, SALISBURY, MD 21804-6952
(410) 749-9290
(410) 543-9087
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1060
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000464928
—
DE
01
—
213769
MAMSI
—
01
—
2353563
AETNA HMO
—
01
—
45227
COVENTRY
—
01
—
5575535
AETNA NON-HMO
—
01
—
57466701
CAREFIRST BLUE CROSS
MD
01
—
6800028
UNITED HEALTHCARE
—
05
—
778441400
—
MD
01
—
PH5
CAREFIRST BLUE CHOICE
MD
Enumeration date
12/14/2006
Last updated
11/26/2007
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