1184780827 NPI number — DR ANDREW G HAHN AND ASSOCIATES OPTOMETRY PA

Table of content: (NPI 1184780827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184780827 NPI number — DR ANDREW G HAHN AND ASSOCIATES OPTOMETRY PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR ANDREW G HAHN AND ASSOCIATES OPTOMETRY PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HAHN EYE CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184780827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1419A MATTHEWS MINT HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MATTHEWS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28105-2308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-847-1030
Provider Business Mailing Address Fax Number:
704-849-8261

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1419A MATTHEWS MINT HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MATTHEWS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28105-2308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-847-1030
Provider Business Practice Location Address Fax Number:
704-849-8261
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
ERICA
Authorized Official Middle Name:
MEREDITH
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
704-847-1030

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  1006 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10048 . This is a "SPECTERA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 25444 . This is a "AVESIS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: NC1006 . This is a "VISION BENEFIT PLAN OF AM" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 02925 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 9879 . This is a "DAVIS VISION" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7902925 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: NC1006 . This is a "EYEMED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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