Healthcare Provider Details

I. General information

NPI: 1235259516
Provider Name (Legal Business Name): LIONS SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 04/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 N TRYON ST STE A
CHARLOTTE NC
28213-7058
US

IV. Provider business mailing address

4600 N TRYON ST STE A
CHARLOTTE NC
28213-7058
US

V. Phone/Fax

Practice location:
  • Phone: 704-599-4760
  • Fax: 704-921-5758
Mailing address:
  • Phone: 704-599-4760
  • Fax: 704-921-5758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberX-0736
License Number StateNC

VIII. Authorized Official

Name: MR. JIM R. CRANFORD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 704-921-1527