Provider Demographics
NPI:1922371392
Name:SAMS SPECS INC
Entity Type:Organization
Organization Name:SAMS SPECS INC
Other - Org Name:OPTICAL FIAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ATTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-744-2411
Mailing Address - Street 1:5646 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1401
Mailing Address - Country:US
Mailing Address - Phone:410-744-2411
Mailing Address - Fax:410-744-2417
Practice Address - Street 1:5646 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-1401
Practice Address - Country:US
Practice Address - Phone:410-744-2411
Practice Address - Fax:410-744-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDA0741152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDA0741OtherLICENSE NUMBER
MD238725Medicare PIN