Provider Demographics
NPI:1477853414
Name:ALAMANCE EYE PROSTHETICS, INC.
Entity Type:Organization
Organization Name:ALAMANCE EYE PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:OCULARIST
Authorized Official - Phone:336-228-1403
Mailing Address - Street 1:1736 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6846
Mailing Address - Country:US
Mailing Address - Phone:336-228-1403
Mailing Address - Fax:336-228-1503
Practice Address - Street 1:1736 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6846
Practice Address - Country:US
Practice Address - Phone:336-228-1403
Practice Address - Fax:336-228-1503
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAMANCE EYE PROSTHETICS,INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-25
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC023UXOtherBCBS
NC023UXOtherBCBS