Provider Demographics
NPI:1922000892
Name:CLAREMONT OPTOMETRIC EYE CARE CENTER, PLLC
Entity Type:Organization
Organization Name:CLAREMONT OPTOMETRIC EYE CARE CENTER, PLLC
Other - Org Name:MOUNTAIN VIEW EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:J.
Authorized Official - Middle Name:RICK
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-294-1010
Mailing Address - Street 1:3038 NC HIGHWAY 127 S
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5404
Mailing Address - Country:US
Mailing Address - Phone:828-294-1010
Mailing Address - Fax:828-294-1013
Practice Address - Street 1:3038 NC HIGHWAY 127 S
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5404
Practice Address - Country:US
Practice Address - Phone:828-294-1010
Practice Address - Fax:828-294-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890903KMedicaid
NC2471822Medicare PIN
NC890903KMedicaid