Organization
HARBOR EYES OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENEAVEE BANK OPTICIAN (PRESIDENT)
(410) 354-6401
Entity
Organization
Contact information
Practice address
3001 S HANOVER ST, GRUEHN BUILDING SUITE 100, BALTIMORE, MD 21225-1233
(410) 354-6401
(410) 354-6401
Mailing address
3001 S HANOVER ST, GRUEHN BUILDING SUITE 100, BALTIMORE, MD 21225-1233
(410) 354-6401
(410) 354-6401
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
30250532
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
579011
ADVANTICA
—
01
—
X420HA
BCBS
MD
Enumeration date
03/07/2007
Last updated
01/18/2008
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