MEDICARE: EYEBRIDGE CONSULTING ASSOCIATES ODPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DG2296	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	018KE	OTHER	NC	BCBSNC

General Provider Information

NPI Number	:	1487624425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEBRIDGE CONSULTING ASSOCIATES ODPA

Provider Business Mailing Address
First Line	:	102 HIDDEN PASTURES DR STE 207
Second Line	:
City	:	CRAMERTON
State	:	NC
Zip	:	28032-1698
Country	:	US
Telephone Number	:	704-616-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 W CHURCH ST
Second Line	:
City	:	CHERRYVILLE
State	:	NC
Zip	:	28021-2805
Country	:	US
Telephone Number	:	704-425-2020
Fax Number	:	704-435-5267

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANN M HOSCHEIT
Credential	:	OD
Telephone Number	:	704-616-8262

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	01/18/2019

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