Myeyedr Optometry of North Carolina, PLLC

Organization Active NPI Optometrist · Mount Holly, NC

NPI 1083434740 · NPPES record last updated Oct 16, 2024

Key facts

NPI
1083434740
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF NORTH CAROLINA, PLLC
Practice address
612 S Main St
Mount Holly, NC 28120-1653
Phone
(704) 822-0099
Fax
(704) 822-0077
NPI assigned
Oct 16, 2024
Organization subpart
No

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Corporate family (same tax ID) 15

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130904000726 NC Part B Supplier - Clinic/Group Practice 6608019096 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Myeyedr Optometry of North Carolina PLLC (55 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

612 S Main St
Mount Holly, NC 28120-1653

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names

  • MyEyeDr. Doing business as

Other providers in Mount Holly, NC

All providers in Mount Holly, NC · Optometrist in North Carolina

Sources for this page

Verify at the official NPI Registry.