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General NPI Number Information
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NPI Number | 1285963314
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Entity Type | Organization
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Legal Business Name | IN HOME OPTICAL INC
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 5330 SOUTH BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28217-4116
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Country | US
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Telephone | 704-525-9802
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Fax | 704-525-3420
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Provider Business Mailing Address
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Address Line | 5330 SOUTH BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28217-4116
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Country | US
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Telephone | 704-525-9802
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Fax | 704-525-3420
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. STANLEY ADAM BATTS
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Credential |
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Telephone | 704-525-9802
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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 | 790
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License Number State | NC
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