Provider Demographics
NPI:1295906329
Name:COVINGTON OPTOMETRIC FAMILY EYE CARE, P.A.
Entity type:Organization
Organization Name:COVINGTON OPTOMETRIC FAMILY EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:COVINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-728-6611
Mailing Address - Street 1:1620 LIVE OAK ST STE A
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-1582
Mailing Address - Country:US
Mailing Address - Phone:252-728-6611
Mailing Address - Fax:252-728-6038
Practice Address - Street 1:1620 LIVE OAK ST STE A
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-1582
Practice Address - Country:US
Practice Address - Phone:252-728-6611
Practice Address - Fax:252-728-6038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1245152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC09206OtherBCBS
NC8909206Medicaid
NC09206OtherBCBSNC
NCT65064Medicare UPIN
NC8909206Medicaid
NC0319210001Medicare NSC