Healthcare Provider Details

I. General information

NPI: 1528007507
Provider Name (Legal Business Name): ALBEMARLE EYE CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 09/02/2025
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 N ROAD ST
ELIZABETH CITY NC
27909-3243
US

IV. Provider business mailing address

1503 N ROAD ST
ELIZABETH CITY NC
27909-3243
US

V. Phone/Fax

Practice location:
  • Phone: 252-335-5446
  • Fax: 252-335-4153
Mailing address:
  • Phone: 252-335-5446
  • Fax: 252-335-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JITENDRA SWARUP
Title or Position: OWNER
Credential: M.D.
Phone: 252-335-5446