Healthcare Provider Details

I. General information

NPI: 1093627218
Provider Name (Legal Business Name): PROFESSIONAL EYE CARE OPTOMETRY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 S MAIN ST
HOPE MILLS NC
28348-1958
US

IV. Provider business mailing address

3701 S MAIN ST
HOPE MILLS NC
28348-1958
US

V. Phone/Fax

Practice location:
  • Phone: 910-423-0700
  • Fax: 910-423-0882
Mailing address:
  • Phone: 910-423-0700
  • Fax: 910-423-0882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN HOLMES
Title or Position: BILLING MANAGER
Credential:
Phone: 910-423-0700