Organization
CAROLINA FAMILY OPTOMETRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY DRENNEN CRIM OD (PARTNER/OWNER)
(704) 872-0616
Entity
Organization
Contact information
Practice address
1116 CROSSROADS DR, STATESVILLE, NC 28625-8277
(704) 872-0616
(704) 872-6494
Mailing address
1116 CROSSROADS DR, STATESVILLE, NC 28625-8277
(704) 872-0616
(704) 872-6494
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1887
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015EX
GROUP NUMBER (BCBS)
NC
Enumeration date
05/03/2006
Last updated
08/22/2020
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