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General NPI Number Information
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NPI Number | 1043416597
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Entity Type | Organization
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Legal Business Name | CAROLINA OPTICAL PARTNERS
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2047 VALLEYGATE DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3688
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Country | US
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Telephone | 910-485-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 1829 DOCTORS DR
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City | SANFORD
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State | NC
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Zip | 27330-5067
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Country | US
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Telephone | 919-776-2032
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DEBORAH L WOODCOCK
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Credential |
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Telephone | 910-485-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | NOT REQUIRED IN SANF
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License Number State | NC
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