Organization
SOUTHEASTERN OCULARISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT HENDERLITE (PRESIDENT)
(704) 510-9292
Entity
Organization
Contact information
Practice address
8426 MEDICAL PLAZA DR, SUITE 500, CHARLOTTE, NC 28262-9746
(704) 510-9292
(704) 510-9881
Mailing address
8426 MEDICAL PLAZA DR, SUITE 500, CHARLOTTE, NC 28262-9746
(704) 510-9292
(704) 510-9881
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DM0376
—
SC
Enumeration date
01/28/2008
Last updated
02/14/2008
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