Mecklenburg Eye Associates PA

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

15966 Issued in SC

Legal business name

MECKLENBURG EYE ASSOCIATES PA

Practice address

724 Arden LN Ste 120
Rock Hill, SC 29732-2995

Phone

(803) 324-2522

Fax

(803) 324-2522

NPI assigned

Sep 3, 2008

Last updated

Sep 28, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles A Boltnick, MD

Title

Vice-President

Phone

(704) 334-2020

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1235387242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 RANDOLPH RD STE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071200",
            "telephone_number": "704-334-2020",
            "fax_number": "704-334-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 ARDEN LN STE 120",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322995",
            "telephone_number": "803-324-2522",
            "fax_number": "803-324-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MECKLENBURG EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "BOLTNICK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "704-334-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "SC",
            "license": "15966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Eyewear Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.