Healthcare Provider Details
I. General information
NPI: 1609005271
Provider Name (Legal Business Name): TRIANGLE OCULAR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/04/2009
Last Update Date: 07/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
208 ASHVILLE AVE SUITE #10
CARY NC
27518-6678
US
IV. Provider business mailing address
309 HILLSPRING LN
HOLLY SPRINGS NC
27540-9416
US
V. Phone/Fax
- Phone: 919-552-5050
- Fax:
- Phone: 919-552-5050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JEFFREY
NEAL
KUBLY
Title or Position: PRESIDENT
Credential:
Phone: 919-552-5050