Provider Demographics
NPI:1043397888
Name:ACCURATE OPTICAL CO OF LAUREL INC
Entity Type:Organization
Organization Name:ACCURATE OPTICAL CO OF LAUREL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-749-1545
Mailing Address - Street 1:31519 WINTERPLACE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1894
Mailing Address - Country:US
Mailing Address - Phone:410-749-1545
Mailing Address - Fax:410-742-3707
Practice Address - Street 1:116 E FRONT ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-1722
Practice Address - Country:US
Practice Address - Phone:302-875-1048
Practice Address - Fax:302-875-3457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000040240Medicaid
DEG02460Medicare PIN
DE5561990001Medicare NSC
DEG02460Medicare UPIN