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Contact Information

BLACK OPTOMETRIC EYE ASSOCIATES,PA
518 W JOHN ST
MATTHEWS, NC28105-5353
 Phone: 704-847-9833
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for BLACK OPTOMETRIC EYE ASSOCIATES,PA

NPI Number 1073788923
LBN Legal business name BLACK OPTOMETRIC EYE ASSOCIATES,PA
Authorized official DEBORAH BLACK - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/22/2008
Last updated 02/21/2010 - About 16 years ago
Identifiers
NC License # 1176
NC Medicaid 8909106
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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