Healthcare Provider Details
I. General information
NPI: 1326157215
Provider Name (Legal Business Name): FAMILY EYE CARE OF THE CAROLINAS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1902 N SANDHILLS BLVD
ABERDEEN NC
28315-2382
US
IV. Provider business mailing address
1902 N SANDHILLS BLVD STE E
ABERDEEN NC
28315-2347
US
V. Phone/Fax
- Phone: 910-692-2020
- Fax: 800-308-9356
- Phone: 910-692-2020
- Fax: 800-308-9356
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0110X |
| Taxonomy | Pediatric Ophthalmology and Strabismus Specialist Physician Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HEATHER
H
DUNN
Title or Position: OFFICE MANAGER
Credential: COA
Phone: 910-692-2020