MEDICARE: CHAPEL HILL EYE CARE ASSOCIATES, OD PLLC

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	1279	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DP8183	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	020VK	OTHER	NC	BLUE CROSS BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427245786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAPEL HILL EYE CARE ASSOCIATES, OD PLLC

Provider Business Mailing Address
First Line	:	7100 SIX FORKS RD
Second Line	:	SUITE 301
City	:	RALEIGH
State	:	NC
Zip	:	27615-6156
Country	:	US
Telephone Number	:	919-847-0187
Fax Number	:	919-676-2231

Provider Business Practice Location Address
First Line	:	1201 RALEIGH RD
Second Line	:	SUITE E
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-4047
Country	:	US
Telephone Number	:	919-942-3320
Fax Number	:	919-942-7268

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN BOLICK
Credential	:
Telephone Number	:	919-847-0187

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	02/11/2013

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