Provider Demographics
NPI:1093776403
Name:WESTERN CAROLINA EYE ASSOCIATES, PA
Entity Type:Organization
Organization Name:WESTERN CAROLINA EYE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-264-0042
Mailing Address - Street 1:610 STATE FARM RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4738
Mailing Address - Country:US
Mailing Address - Phone:828-264-0042
Mailing Address - Fax:828-264-8612
Practice Address - Street 1:610 STATE FARM RD
Practice Address - Street 2:SUITE A
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4738
Practice Address - Country:US
Practice Address - Phone:828-264-0042
Practice Address - Fax:828-264-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4317OtherPARTNERS MEDICARE
NC0291BOtherBCBS
NC890291BMedicaid
CE1797OtherRR MEDICARE
TN4401146OtherBLUECARE/CAID DUAL
1364673OtherUMWA
TN67587OtherBLUECARE
NC40013OtherMEDCOST
TN4401146OtherBLUECARE/CAID DUAL
NY230497Medicare ID - Type UnspecifiedMEDICARE