Organization
EYECARECENTER OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH ALLAN GREGG OD (PRESIDENT)
(252) 451-5324
Entity
Organization
Contact information
Practice address
509 LAUCHWOOD DR, LAURINBURG, NC 28352-5502
(636) 200-4393
(910) 276-9254
Mailing address
PO BOX 207261, DALLAS, TX 75320-7261
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222680043
SUPPLIER NUMBER
NC
Enumeration date
01/24/2017
Last updated
06/20/2019
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