| Colonial Opticians Inc. | |
|
718 Center Point Way Gaithersburg MD 20878-6469 | |
| (301) 990-0398 | |
| (303) 990-9486 |
| Full Name | Colonial Opticians Inc. |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 718 Center Point Way, Gaithersburg, Maryland |
| Authorized Official Name and Position | Karen Melissa Williams (PRESIDENT) |
| Authorized Official Contact | 3016573332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Opticians Inc. 718 Center Point Way Gaithersburg MD 20878-6469 Ph: (301) 990-0398 | Colonial Opticians Inc. 718 Center Point Way Gaithersburg MD 20878-6469 Ph: (301) 990-0398 |
| NPI Number | 1912164070 |
|---|---|
| Provider Enumeration Date | 05/16/2008 |
| Last Update Date | 09/11/2020 |
| Medicare PECOS PAC ID | 6305260134 |
|---|---|
| Medicare Enrollment ID | O20200727000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912164070 | NPI | - | NPPES |
| OP0914 | Other | EYEMED | |
| OP0914 | Other | MD | EYEMED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 15302753 (Maryland) | Primary |
| Provider Name | Angela C Grillo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245337583 PECOS PAC ID: 4981703378 Enrollment ID: I20080717000187 |
| Provider Name | Dalia Nader Elkassabany |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134657885 PECOS PAC ID: 0547507063 Enrollment ID: I20200923002177 |
| Provider Name | Huda Khan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407318280 PECOS PAC ID: 0648512210 Enrollment ID: I20210709001304 |
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