1285644500 NPI number — NEW CENTURY OPHTHALMOLOGY, PC

Table of content: (NPI 1285644500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285644500 NPI number — NEW CENTURY OPHTHALMOLOGY, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW CENTURY OPHTHALMOLOGY, PC
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:
Provider Other Organization Name Type Code:
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:
1285644500
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 914
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXFORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27565-0914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-693-6661
Provider Business Mailing Address Fax Number:
919-690-1160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1610 WILLIAMSBORO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27565-5016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-693-6661
Provider Business Practice Location Address Fax Number:
919-690-1160
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JINDAL
Authorized Official First Name:
VINOD
Authorized Official Middle Name:
KUMAR
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
919-693-6661

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  NC200000836 , 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: 278888 . This is a "ANTHEM" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: OPH158 . This is a "PRIMAHEALTH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 129K5 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 296327 . This is a "MAMSI/ALLIANCE PPO" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 160963 . This is a "WELLPATH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7957242 . This is a "RJ REYNOLDS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 180043366 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1046375 . This is a "CIGNA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1057205 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: B2572 . This is a "MEDCOST" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 89129K5 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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