Provider Demographics
NPI:1043659873
Name:DELAWARE OPHTHALMOLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:DELAWARE OPHTHALMOLOGY CONSULTANTS PA
Other - Org Name:DOC OPTICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-477-2611
Mailing Address - Street 1:3501 SILVERSIDE RD
Mailing Address - Street 2:NAAMANS BLDG.
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4910
Mailing Address - Country:US
Mailing Address - Phone:302-477-2611
Mailing Address - Fax:302-477-2650
Practice Address - Street 1:272 CARTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5852
Practice Address - Country:US
Practice Address - Phone:302-477-2626
Practice Address - Fax:302-477-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier