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General NPI Number Information
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NPI Number | 1720243363
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Entity Type | Organization
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Legal Business Name | WINSTON SALEM INDUSTRIES FOR THE BLIND
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 7730 N POINT BLVD OPTICAL DISPENSARY
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3310
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Country | US
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Telephone | 336-759-2257
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Fax | 336-759-7778
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Provider Business Mailing Address
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Address Line | 7730 N POINT BLVD OPTICAL DISPENSARY
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3310
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Country | US
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Telephone | 336-759-0551
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Fax | 336-759-7778
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Authorized Official
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Title or Position | OPTICAL OPERATIONS MANAGER
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Name | MR. GEORGE C GOODWIN JR.
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Credential | A.B.O
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Telephone | 336-245-5628
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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 | NC
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