MEDICARE: DR. EDWARD NEIL BARENTINE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1976	NC

General Provider Information

NPI Number	:	1164440350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD NEIL BARENTINE O.D.

Provider Business Mailing Address
First Line	:	1046 MCLAURIN RD
Second Line	:	GREEN PASTURES FARM
City	:	SILER CITY
State	:	NC
Zip	:	27344-7585
Country	:	US
Telephone Number	:	919-937-5700
Fax Number	:	919-837-5700

Provider Business Practice Location Address
First Line	:	1046 MCLAURIN RD
Second Line	:	GREEN PASTURES FARM
City	:	SILER CITY
State	:	NC
Zip	:	27344-7585
Country	:	US
Telephone Number	:	919-937-5700
Fax Number	:	919-837-5700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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