| Ckfogleman Od, Pllc | |
|
1205 Floral Pkwy Wilmington NC 28403-6216 | |
| (910) 791-6086 | |
| Not Available |
| Full Name | Ckfogleman Od, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1205 Floral Pkwy, Wilmington, North Carolina |
| Authorized Official Name and Position | Caroline Kaleel Fogleman (OPTOMETRIST) |
| Authorized Official Contact | 9107916086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ckfogleman Od, Pllc 3216 Red Berry Dr Wilmington NC 28409-2522 Ph: (704) 778-1172 | Ckfogleman Od, Pllc 1205 Floral Pkwy Wilmington NC 28403-6216 Ph: (910) 791-6086 |
| NPI Number | 1790388973 |
|---|---|
| Provider Enumeration Date | 11/19/2020 |
| Last Update Date | 11/19/2020 |
| Medicare PECOS PAC ID | 8527474121 |
|---|---|
| Medicare Enrollment ID | O20210305001062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790388973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Edward Weaver |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346245263 PECOS PAC ID: 4880654169 Enrollment ID: I20041012000818 |
| Provider Name | Caroline Kaleel Fogleman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427570639 PECOS PAC ID: 5890040398 Enrollment ID: I20180625003093 |
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