Provider Demographics
NPI:1073905931
Name:CAROLYN V ORMES OD LLC
Entity Type:Organization
Organization Name:CAROLYN V ORMES OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ORMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-834-6400
Mailing Address - Street 1:15 E POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MD
Mailing Address - Zip Code:21716-1409
Mailing Address - Country:US
Mailing Address - Phone:301-834-6400
Mailing Address - Fax:301-834-7585
Practice Address - Street 1:15 E POTOMAC ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MD
Practice Address - Zip Code:21716-1409
Practice Address - Country:US
Practice Address - Phone:301-834-6400
Practice Address - Fax:301-834-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA-2288261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center