Provider Demographics
NPI:1306027677
Name:LOW VISION SPECIALIST, INC.
Entity Type:Organization
Organization Name:LOW VISION SPECIALIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEELE-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-572-2888
Mailing Address - Street 1:1496 STILL MEADOW BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7512
Mailing Address - Country:US
Mailing Address - Phone:410-572-2888
Mailing Address - Fax:410-572-2808
Practice Address - Street 1:1496 STILL MEADOW BLVD STE G
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-7512
Practice Address - Country:US
Practice Address - Phone:410-572-2888
Practice Address - Fax:410-572-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1695152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD794MMedicare PIN