Provider Demographics
NPI:1306254941
Name:EYEFIT VISION CENTERS
Entity type:Organization
Organization Name:EYEFIT VISION CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OPERATIONS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-896-0710
Mailing Address - Street 1:2111 VAN DEMAN STREET
Mailing Address - Street 2:2NC FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224
Mailing Address - Country:US
Mailing Address - Phone:443-896-0710
Mailing Address - Fax:612-367-0841
Practice Address - Street 1:7550 TEAGUE ROAD
Practice Address - Street 2:SUITE 114
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076
Practice Address - Country:US
Practice Address - Phone:410-799-8067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALTY BENEFITS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty