Provider Demographics
NPI:1467467126
Name:ACCURATE OPTICAL CO OF CAMBRIDGE INC
Entity Type:Organization
Organization Name:ACCURATE OPTICAL CO OF CAMBRIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-749-1545
Mailing Address - Street 1:31519 WINTERPLACE PARKWAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804
Mailing Address - Country:US
Mailing Address - Phone:410-749-1545
Mailing Address - Fax:410-742-3707
Practice Address - Street 1:610 SHOAL CREEK MALL
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613
Practice Address - Country:US
Practice Address - Phone:410-228-1110
Practice Address - Fax:410-228-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0823152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD331148100Medicaid
MD0400310001Medicare NSC
MD331148100Medicaid
MD353LMedicare ID - Type Unspecified