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General NPI Number Information
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NPI Number | 1497228688
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Entity Type | Organization
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Legal Business Name | HAMPSTEAD OPTOMETRY PA
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 16747 US HIGHWAY 17 N STE 140
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City | HAMPSTEAD
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State | NC
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Zip | 28443-3695
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Country | US
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Telephone | 910-507-2019
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Fax | 910-363-0342
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Provider Business Mailing Address
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Address Line | 12910 SHELBYVILLE RD STE 300
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City | LOUISVILLE
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State | KY
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Zip | 40243-2404
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Country | US
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Telephone | 502-244-2441
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Fax | 502-254-4069
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Authorized Official
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Title or Position | OWNER
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Name | LORI FARABAUGH
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Credential | OD
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Telephone | 910-507-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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