| |
161 Westwood Shopping Ctr, Fayetteville, NC 28314-1521 | |
(910) 864-6070 | |
(910) 864-4036 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 161 Westwood Shopping Ctr, Fayetteville, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568636090 | NPI | - | NPPES |
09220 | Other | NC | BLUE CROSS BLUE SHIELD |
8909220 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
161 Westwood Shopping Ctr, Fayetteville, NC 28314-1521 Ph: (910) 864-6070 | 161 Westwood Shopping Ctr, Fayetteville, NC 28314-1521 Ph: (910) 864-6070 |