Provider Demographics
NPI:1336432301
Name:ALBEMARLE EYE CENTER, PLLC
Entity Type:Organization
Organization Name:ALBEMARLE EYE CENTER, PLLC
Other - Org Name:PRECISION EYE CARE A DIVISION OF ALBEMARLE EYE CENTER, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARUP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-335-5446
Mailing Address - Street 1:1503 N ROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3243
Mailing Address - Country:US
Mailing Address - Phone:252-335-5446
Mailing Address - Fax:252-335-4153
Practice Address - Street 1:1730 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3315
Practice Address - Country:US
Practice Address - Phone:252-946-2171
Practice Address - Fax:252-946-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1263730005Medicare NSC