Provider Demographics
NPI:1346302882
Name:ALAMANCE EYE CARE, PA
Entity Type:Organization
Organization Name:ALAMANCE EYE CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DINGELDEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-228-0254
Mailing Address - Street 1:1016 KIRKPATRICK ROAD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-9714
Mailing Address - Country:US
Mailing Address - Phone:336-228-0254
Mailing Address - Fax:336-584-0101
Practice Address - Street 1:1828 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE B14
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7415
Practice Address - Country:US
Practice Address - Phone:919-967-0670
Practice Address - Fax:919-942-5873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89012P7Medicaid
NC89012P7Medicaid
NC2470977Medicare PIN