Organization
HOMETOWN SPECS EMPORIUM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY JACKSON SMURR OD (PRESIDENT)
(352) 521-3011
Entity
Organization
Contact information
Practice address
13940 7TH ST, DADE CITY, FL 33525-4904
(352) 521-3011
(352) 521-7163
Mailing address
13940 7TH ST, DADE CITY, FL 33525-4904
(352) 521-3011
(352) 521-7163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2393
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20246
BCBS
FL
01
—
4609006
AETNA
—
Enumeration date
04/18/2007
Last updated
07/21/2008
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