Provider Demographics
NPI:1578592846
Name:CAPITAL EYE CARE, DOCTORS OF OPTOMETRY, PC
Entity Type:Organization
Organization Name:CAPITAL EYE CARE, DOCTORS OF OPTOMETRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HEROLD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-359-0770
Mailing Address - Street 1:5000 BAKERS MILL LN STE 170
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2432
Mailing Address - Country:US
Mailing Address - Phone:804-359-0770
Mailing Address - Fax:804-359-1106
Practice Address - Street 1:5000 BAKERS MILL LN STE 170
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2432
Practice Address - Country:US
Practice Address - Phone:804-359-0770
Practice Address - Fax:804-359-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0603000341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09852OtherPTAN