Provider Demographics
NPI:1487847711
Name:OLNEY OPTICIANS,INC.
Entity Type:Organization
Organization Name:OLNEY OPTICIANS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-774-2434
Mailing Address - Street 1:3423 OLNEY-LAYTONSVILLE ROAD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-774-2434
Mailing Address - Fax:
Practice Address - Street 1:3423 OLNEY LAYTONSVILLE RD
Practice Address - Street 2:STE 2
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3708
Practice Address - Country:US
Practice Address - Phone:301-774-2434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0730680001Medicare NSC