MOBILE OPTICAL SERVICE, LLC (NPI# 1447402193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447402193 |
| Entity Type | Organization |
| Organization Name | MOBILE OPTICAL SERVICE, LLC |
| Practice Address |
4200 Elderon Ave Baltimore MD 21215-4802 |
| Practice Telephone | 4106644508 |
| Practice Fax Number | 4106640605 |
| Mailing Telephone | 4106644508 |
| Mailing Fax Number | 4106640605 |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |
| Authorized Official Name | MR. DAVID KENNETH JACKSON (OWNER & OPTICIAN) |
| Authorized Official Telephone | 4106644508 |
| Authorized Official Credential | ABOC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 072195 | MD | Suppliers |
| Street Address |
4200 ELDERON AVE |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21215-4802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851566467 | David Kenneth Jackson | Technician/Technologist | 4200 Elderon Ave, Baltimore, MD 21215-4802 | 2008-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639736796 | Talal Abalkhail | Student in an Organized Health Care Education/Training Program | 2401 W. Belvedere Avenue, Baltimore, Md 21215, Baltimore, MD 21215 | 2019-05-23 |
| 1235795410 | Bilal Khan | Student in an Organized Health Care Education/Training Program | 2041 West Belvedere Avenue, Balitmore, MD 21215 | 2019-05-14 |
| 1669036067 | Nasir M Alhamdan | Student in an Organized Health Care Education/Training Program | Of Baltimore, 2401 West Belvedere Ave, Baltimore, MD 21215 | 2019-05-01 |
| 1851863971 | Brittany Michelle O'neill | Specialist/Technologist | Hearing and Speech Agency, 5900 Metro Drive, Baltimore, MD 21215 | 2018-12-31 |
| 1881164432 | Emily Gamma | Social Worker | 4810 Seton Drive, Baltimore, MD 21215 | 2018-11-27 |
| 1518440478 | Benson Baby | Physical Therapist | 2525west Belveder Ave, Baltimore, MD 21215 | 2018-09-07 |
| 1609360817 | Bonnie Kahler | Clinical Nurse Specialist | 2401 Belvedere Avenue, Baltimore, MD 21215 | 2018-06-20 |
| 1932693843 | Kelley Monica Cohill | Social Worker | Sinai Hospital, Department of Psychiatry, 2440 Cylburn Ave., Baltimore, MD 21215 | 2018-06-15 |
| 1497245609 | Kimberly Beth Koerner | Social Worker | 2401 W. Belvedere Avenue, Baltimore, MD 21215 | 2018-05-14 |
| 1184113078 | Mary Jo Kozel | Registered Nurse | 2401 West Belvedere, Baltimore, MD 21215 | 2018-05-07 |
| Find all providers in zip 21215 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720608573 | Optilens Vision Center | Eyewear Supplier (Equipment, not the service) | 1490 W Patapsco Ave Ste E, Baltimore, MD 21230-3400 | 2020-04-22 |
| 1598130999 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4701 Odonnell St, Baltimore, MD 21224-5303 | 2015-12-10 |
| 1568662542 | Essilor Laboratories of America, Inc. | Eyewear Supplier (Equipment, not the service) | 1107 Wilso Dr, Baltimore, MD 21223-3230 | 2007-07-19 |
| 1821292236 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 2400 Boston St Ste 106, Baltimore, MD 21224-4780 | 2007-06-12 |
| 1699829200 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 4201 Wholesale Club, Baltimore, MD 21236 | 2007-01-22 |
| 1053478339 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 6901 Security Blvd, Baltimore, MD 21244 | 2007-01-03 |
| 1043374184 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 8200 Perry Hall Blvd Ste 2036, Baltimore, MD 21236-4042 | 2006-12-21 |
| 1528132958 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 7885 East Point Mall, Baltimore, MD 21224-2116 | 2006-11-18 |
| 1760567226 | For Eyes Optical Co. of Pennsylvania | Eyewear Supplier (Equipment, not the service) | 330 N Charles St, Baltimore, MD 21201-4304 | 2006-10-25 |
| 1548281686 | Debrouse Opticians | Eyewear Supplier (Equipment, not the service) | 7601 1/2 Harford Rd, Baltimore, MD 21234-6401 | 2006-07-22 |
| Find all providers in BALTIMORE | ||||
Please comment or provide details below to improve the information on MOBILE OPTICAL SERVICE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.