Provider Demographics
NPI:1942604608
Name:GLOBAL COMPLEX EYE CARE LLC
Entity Type:Organization
Organization Name:GLOBAL COMPLEX EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLINGSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:410-660-2646
Mailing Address - Street 1:2219 YORK ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3140
Mailing Address - Country:US
Mailing Address - Phone:410-660-2646
Mailing Address - Fax:
Practice Address - Street 1:2219 YORK ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3140
Practice Address - Country:US
Practice Address - Phone:410-660-2646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty