Provider Demographics
NPI:1710053657
Name:EASTERN EYE ASSOCIATES OF PITT-GREENE, OD PA
Entity Type:Organization
Organization Name:EASTERN EYE ASSOCIATES OF PITT-GREENE, OD PA
Other - Org Name:DOCTORS VISION CENTER OF FARMVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHERTZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-753-5567
Mailing Address - Street 1:3681B N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27828-1464
Mailing Address - Country:US
Mailing Address - Phone:252-753-5567
Mailing Address - Fax:252-753-5568
Practice Address - Street 1:3681B N MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:NC
Practice Address - Zip Code:27828-1464
Practice Address - Country:US
Practice Address - Phone:252-753-5567
Practice Address - Fax:252-753-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0971152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7909799Medicaid
NC8901651Medicare ID - Type Unspecified
NC7909799Medicaid