Healthcare Provider Details
I. General information
NPI: 1427165810
Provider Name (Legal Business Name): TOWN CENTER EYE CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2006
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1503 ENTERPRISE DR
LYNCHBURG VA
24502-5751
US
IV. Provider business mailing address
PO BOX 45923
BALTIMORE MD
21297-5923
US
V. Phone/Fax
- Phone: 434-832-0700
- Fax: 434-832-0736
- Phone: 877-969-0392
- Fax: 434-385-1414
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
BURTON
Title or Position: INSURANCE MANAGER
Credential:
Phone: 877-969-0392