| |
405 Parkway, Ste B, Greensboro, NC 27401 | |
(336) 274-2441 | |
(336) 274-2565 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 405 Parkway, Greensboro, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013936111 | NPI | - | NPPES |
8936504 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1951 (North Carolina) | Secondary |
207W00000X | Ophthalmology | 21562 (North Carolina) | Primary |
Mailing Address | Practice Location Address |
---|---|
405 Parkway, Ste B, Greensboro, NC 27401 Ph: (336) 274-2441 | 405 Parkway, Ste B, Greensboro, NC 27401 Ph: (336) 274-2441 |