Organization
PEMBROKE OPTOMETRIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA KAYE LOCKLEAR OD (PRESIDENT)
(910) 521-9744
Entity
Organization
Contact information
Practice address
204 UNION CHAPEL RD, PEMBROKE, NC 28372-2109
(910) 521-9744
(910) 521-1310
Mailing address
PO BOX 2109, PEMBROKE, NC 28372-2109
(910) 521-9744
(910) 521-1310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1318
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8909451
—
NC
Enumeration date
12/05/2005
Last updated
02/12/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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