Provider Demographics
NPI:1538645825
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:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-964-8532
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 1:101 MARK DR
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932
Practice Address - Country:US
Practice Address - Phone:252-482-7471
Practice Address - Fax:252-482-5465
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBEMARLE EYE CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-19
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24730207W00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty