| |
1565 Purdue Dr Ste 301, Fayetteville, NC 28303-5537 | |
(910) 615-3150 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Technician/technologist - Ophthalmic |
Location | 1565 Purdue Dr Ste 301, Fayetteville, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942755384 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | H0213 (North Carolina) | Secondary |
156FX1100X | Technician/technologist - Ophthalmic | H0213 (North Carolina) | Primary |
Mailing Address | Practice Location Address |
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Po Box 40908, Attn: Managed Care Planning, Fayetteville, NC 28309-0908 Ph: (910) 615-6949 | 1565 Purdue Dr Ste 301, Fayetteville, NC 28303-5537 Ph: (910) 615-3150 |