Provider Demographics
NPI:1518427368
Name:CAPITAL EYE CARE LLC
Entity Type:Organization
Organization Name:CAPITAL EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:CHERISSE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-530-5200
Mailing Address - Street 1:6720A ROCKLEDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-9915
Mailing Address - Country:US
Mailing Address - Phone:301-530-5200
Mailing Address - Fax:301-530-5202
Practice Address - Street 1:3289 WOODBURN RD STE 270
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7351
Practice Address - Country:US
Practice Address - Phone:703-849-8601
Practice Address - Fax:703-849-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty