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Organization

COASTAL OPTICAL OF WILMINGTON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MAX GILBERT SOX JR. (OPTICIAN/OWNER)
(910) 763-2532
Entity
Organization

Contact information

Practice address
1120 MEDICAL CENTER DR, WILMINGTON, NC 28401-7305
(910) 763-2532
(910) 762-1292
Mailing address
1120 MEDICAL CENTER DR, WILMINGTON, NC 28401-7305
(910) 763-2532
(910) 762-1292

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
594
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8802139
NC
Enumeration date
10/08/2009
Last updated
10/26/2009
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