Provider Demographics
NPI:1174657951
Name:CAROLINA VISION CARE, LLC
Entity Type:Organization
Organization Name:CAROLINA VISION CARE, LLC
Other - Org Name:JEFFREY A HARVEY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-527-8804
Mailing Address - Street 1:703 ROSANNE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-1551
Mailing Address - Country:US
Mailing Address - Phone:252-527-8804
Mailing Address - Fax:252-527-4379
Practice Address - Street 1:703 ROSANNE DR
Practice Address - Street 2:SUITE B
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504-1551
Practice Address - Country:US
Practice Address - Phone:252-527-8804
Practice Address - Fax:252-527-4379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC1565152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0121UOtherBCBS OTHER
NC890121UMedicaid
NC2467759CMedicare PIN