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General NPI Number Information
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NPI Number | 1861465205
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Entity Type | Organization
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Legal Business Name | CAROLINA EYE PROSTHETICS, INC.
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 420 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-5934
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Country | US
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Telephone | 336-228-7877
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Fax | 336-228-7514
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Provider Business Mailing Address
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Address Line | 420 MAPLE AVE
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City | BURLINGTON
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State | NC
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Zip | 27215-5934
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Country | US
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Telephone | 336-228-7877
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Fax | 336-228-7514
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ANNA BOYD JEFFERSON
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Credential | BCO
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Telephone | 336-228-7877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 335E00000X
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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