Provider Demographics
NPI:1851358642
Name:CAPITAL VISION CENTER INC
Entity Type:Organization
Organization Name:CAPITAL VISION CENTER INC
Other - Org Name:DRS. SMITH AND SARACINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:SARACINO
Authorized Official - Suffix:
Authorized Official - Credentials:OD, MS
Authorized Official - Phone:717-657-3682
Mailing Address - Street 1:4854 LONDONDERRY RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5207
Mailing Address - Country:US
Mailing Address - Phone:717-657-3682
Mailing Address - Fax:
Practice Address - Street 1:4854 LONDONDERRY RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5207
Practice Address - Country:US
Practice Address - Phone:717-657-3682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001502152W00000X
PAOEG000015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV04062Medicare UPIN
PAU62976Medicare UPIN