Provider Demographics
NPI:1710309422
Name:ANIMAL EYE CARE
Entity Type:Organization
Organization Name:ANIMAL EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERINARY OPHTHALMOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:405-706-6438
Mailing Address - Street 1:197 DEFENSE HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7074
Mailing Address - Country:US
Mailing Address - Phone:410-224-4260
Mailing Address - Fax:410-224-4946
Practice Address - Street 1:197 DEFENSE HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401
Practice Address - Country:US
Practice Address - Phone:410-422-4260
Practice Address - Fax:410-224-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6975284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital