=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487624425
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EYEBRIDGE CONSULTING ASSOCIATES ODPA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2006
-----------------------------------------------------
Last Update Date | 01/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 W CHURCH ST
-----------------------------------------------------
City | CHERRYVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28021-2805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-425-2020
-----------------------------------------------------
Fax | 704-435-5267
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 102 HIDDEN PASTURES DR STE 207
-----------------------------------------------------
City | CRAMERTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28032-1698
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-616-8262
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ANN M HOSCHEIT
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 704-616-8262
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------