Provider Demographics
NPI:1528007507
Name:ALBEMARLE EYE CENTER, PLLC
Entity Type:Organization
Organization Name:ALBEMARLE EYE CENTER, PLLC
Other - Org Name:PRECISION OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARUP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-335-5446
Mailing Address - Street 1:1503 N ROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3243
Mailing Address - Country:US
Mailing Address - Phone:252-335-5446
Mailing Address - Fax:252-335-4153
Practice Address - Street 1:1503 N ROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3243
Practice Address - Country:US
Practice Address - Phone:252-335-5446
Practice Address - Fax:252-335-4153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCI9223OtherRAILROAD MEDIARE
NC1263730002Medicare NSC
NC2471877Medicare PIN
NCCI9223OtherRAILROAD MEDIARE