Provider Demographics
NPI:1275123929
Name:U CARE I CARE OPTOMETRIC SERVICES PLLC
Entity Type:Organization
Organization Name:U CARE I CARE OPTOMETRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARHONDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HARRILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-575-1033
Mailing Address - Street 1:311 N WIND DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-9200
Mailing Address - Country:US
Mailing Address - Phone:704-575-1033
Mailing Address - Fax:
Practice Address - Street 1:611 COLISEUM DR STE B
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5310
Practice Address - Country:US
Practice Address - Phone:336-502-7222
Practice Address - Fax:336-232-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1295129773Medicaid