Provider Demographics
NPI:1659821528
Name:REFOCUS EYE CARE, PLLC
Entity Type:Organization
Organization Name:REFOCUS EYE CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAFEEZAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:224-725-8423
Mailing Address - Street 1:1600 BAITY HILL DR APT 126
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3956
Mailing Address - Country:US
Mailing Address - Phone:224-725-8423
Mailing Address - Fax:
Practice Address - Street 1:515 MOUNT CROSS RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4065
Practice Address - Country:US
Practice Address - Phone:224-725-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002517305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1952856700OtherNPPES