Provider Demographics
NPI:1689806747
Name:CEL O.D. PLLC
Entity Type:Organization
Organization Name:CEL O.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:LEMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-766-0345
Mailing Address - Street 1:6634 APRIL MIST TRL
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2322
Mailing Address - Country:US
Mailing Address - Phone:704-766-0345
Mailing Address - Fax:
Practice Address - Street 1:10230 BERKELEY PLACE DR STE 140
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1203
Practice Address - Country:US
Practice Address - Phone:704-971-5002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CEL O.D. PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911225Medicaid