Provider Demographics
NPI:1013218841
Name:NEW MOUNTAIN EYE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:NEW MOUNTAIN EYE ASSOCIATES PLLC
Other - Org Name:MOUNTAIN EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-452-5816
Mailing Address - Street 1:486 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8026
Mailing Address - Country:US
Mailing Address - Phone:828-452-5816
Mailing Address - Fax:828-452-0373
Practice Address - Street 1:486 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:NC
Practice Address - Zip Code:28721-8026
Practice Address - Country:US
Practice Address - Phone:828-452-5816
Practice Address - Fax:828-452-0373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW MOUNTAIN EYE ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0256VOtherBCBS
NC890256VMedicaid
NC0256VOtherBCBS