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General NPI Number Information
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NPI Number | 1679112122
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Entity Type | Organization
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Legal Business Name | GLENPOINTE OPTICAL CORP
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 9831 REA RD STE G
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City | CHARLOTTE
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State | NC
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Zip | 28277-6655
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Country | US
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Telephone | 864-650-2088
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Fax |
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Provider Business Mailing Address
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Address Line | 16615 DOVES CANYON LN
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City | CHARLOTTE
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State | NC
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Zip | 28278-8111
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Country | US
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Telephone | 864-650-2088
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOEL BENJAMIN JENNINGS
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Credential |
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Telephone | 864-650-2088
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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 |
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License Number State |
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