Provider Demographics
NPI:1871596494
Name:HAGER OPTICAL, INCORPORATED
Entity type:Organization
Organization Name:HAGER OPTICAL, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-739-7713
Mailing Address - Street 1:251 E BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6144
Mailing Address - Country:US
Mailing Address - Phone:301-739-7713
Mailing Address - Fax:301-739-7717
Practice Address - Street 1:251 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6144
Practice Address - Country:US
Practice Address - Phone:301-739-7713
Practice Address - Fax:301-739-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0413370001Medicare NSC