Eye Tech Optical Inc

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

335 Issued in NC

Legal business name

EYE TECH OPTICAL INC

Doing business as

Eye Tech Optical

Practice address

1800 N Skibo Rd
Suite 148 a
Fayetteville, NC 28303-3485

Phone

(910) 487-1863

Fax

(910) 487-5018

NPI assigned

Feb 26, 2007

Last updated

Aug 22, 2020By 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

Mr. Mark Lee Hathaway, OPTICIANNPI 1659577021

Title

President

Phone

(910) 487-1863

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eye Tech Optical Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Lee Hathaway, OPTICIAN

  • Optician
  • Fayetteville, NC
  • NPI 1659577021
  NPD (past) Authorized official

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598891137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N SKIBO RD",
            "address_2": "SUITE 148 A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033485",
            "telephone_number": "910-487-1863",
            "fax_number": "910-487-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N SKIBO RD",
            "address_2": "SUITE 148 A",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033485",
            "telephone_number": "910-487-1863",
            "fax_number": "910-487-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE TECH OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-487-1863",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "136935",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Tech Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Eyewear Supplier in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.