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KELLY EYE CENTER NPI 1700036357


NPI Information

NPI: 1700036357
Provider Name: KELLY EYE CENTER
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization

CLIA Number: 34D2119240

Address:
10321 LUMLEY RD
SUITE 200
RALEIGH, NC
ZIP 27617
Phone: (919) 282-1100
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KELLY EYE CENTER is an eyewear supplier in Raleigh, NC. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. KELLY EYE CENTER NPI is 1700036357. The provider is registered as an organization entity type.

The provider's business location address is:

10321 LUMLEY RD
SUITE 200
RALEIGH, NC
ZIP 27617-640
Phone: (919) 282-1100
Fax: (919) 282-1119

The provider's authorized official is Maridy E Knight .
The authorized official title is Insurance Manager and has the following contact phone number (919) 282-1100.

The CLIA number assigned to this NPI record is 34D2119240 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2008 and was last updated on 9/19/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18802107MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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