Provider Demographics
NPI:1144260662
Name:WHEELER'S OPTICAL INC.
Entity type:Organization
Organization Name:WHEELER'S OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-678-6993
Mailing Address - Street 1:263 N PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21750-1042
Mailing Address - Country:US
Mailing Address - Phone:301-678-6993
Mailing Address - Fax:301-678-6434
Practice Address - Street 1:263 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MD
Practice Address - Zip Code:21750-1042
Practice Address - Country:US
Practice Address - Phone:301-678-6993
Practice Address - Fax:301-678-6434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15715156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0297500001Medicare NSC
MD02975000001Medicare ID - Type Unspecified