Provider Demographics
NPI:1538302237
Name:ROCKVILLE EYE CARE LLC
Entity Type:Organization
Organization Name:ROCKVILLE EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:301-762-2223
Mailing Address - Street 1:414 HUNGERFORD DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4125
Mailing Address - Country:US
Mailing Address - Phone:301-762-2223
Mailing Address - Fax:301-762-1075
Practice Address - Street 1:414 HUNGERFORD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4125
Practice Address - Country:US
Practice Address - Phone:301-762-2223
Practice Address - Fax:301-762-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA 1774152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
151501Medicare PIN