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General NPI Number Information
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NPI Number | 1639142656
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Entity Type | Organization
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Legal Business Name | GREENSBORO OPHTHALMOLOGY ASC LLC
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 3312 BATTLEGROUND AVENUE
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City | GREENSBORO
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State | NC
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Zip | 27410-2402
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Country | US
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Telephone | 336-282-8331
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Fax | 336-282-2625
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Provider Business Mailing Address
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Address Line | 3312 BATTLEGROUND AVENUE
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City | GREENSBORO
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State | NC
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Zip | 27410-2402
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Country | US
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Telephone | 336-282-8331
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Fax | 336-282-2625
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Authorized Official
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Title or Position | MANAGER
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Name | DAWN D APPLE
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Credential |
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Telephone | 910-255-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | AS0033
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License Number State | NC
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