Provider Demographics
NPI:1053322933
Name:STEPHANIE PRICE-HARRIS, O.D., P.A.
Entity Type:Organization
Organization Name:STEPHANIE PRICE-HARRIS, O.D., P.A.
Other - Org Name:O.C. EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:PRICE-HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-213-9020
Mailing Address - Street 1:12417 OCEAN GTWY
Mailing Address - Street 2:SUITE #14
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-9521
Mailing Address - Country:US
Mailing Address - Phone:410-213-9020
Mailing Address - Fax:410-213-9030
Practice Address - Street 1:12417 OCEAN GTWY
Practice Address - Street 2:SUITE #14
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-9521
Practice Address - Country:US
Practice Address - Phone:410-213-9020
Practice Address - Fax:410-213-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1788152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6172000001Medicare NSC
MD00Y716Medicare PIN