Healthcare Provider Details

I. General information

NPI: 1174646533
Provider Name (Legal Business Name): EYE PROS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 SHARON RD LEVEL 4 BELK
CHARLOTTE NC
28211-3531
US

IV. Provider business mailing address

4400 SHARON RD LEVEL 4 BELK
CHARLOTTE NC
28211-3531
US

V. Phone/Fax

Practice location:
  • Phone: 704-362-0098
  • Fax: 704-362-0098
Mailing address:
  • Phone: 704-362-0098
  • Fax: 704-362-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number289
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES MICHAEL STONE
Title or Position: OWNER
Credential: LICENSED OPTICIAN
Phone: 704-362-0098