Healthcare Provider Details

I. General information

NPI: 1699342154
Provider Name (Legal Business Name): EMMA BOYD BCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E BESSEMER AVE
GREENSBORO NC
27401-1415
US

IV. Provider business mailing address

613 N GURNEY ST
BURLINGTON NC
27215-4526
US

V. Phone/Fax

Practice location:
  • Phone: 336-266-5051
  • Fax:
Mailing address:
  • Phone: 336-266-5051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: