MODERN OPTICAL, INC (NPI# 1073642054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073642054 |
| Entity Type | Organization |
| Organization Name | MODERN OPTICAL, INC |
| Practice Address |
2648 Lee Ave Sanford NC 27332-5950 |
| Practice Telephone | 9197755221 |
| Mailing Telephone | 9197755221 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | MR. ROGER DWIGHT THOMAS SR. (OWNER) |
| Authorized Official Telephone | 9197755221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
0710 | NC | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8801952 | 05 |
| Street Address |
2648 LEE AVE |
| City | SANFORD |
| State | NC |
| Zip Code | 27332-5950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356470322 | Roger Dwight Thomas Sr. | Technician/Technologist | 2648 Lee Ave, Sanford, NC 27332-5950 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932629847 | Jessica Lane Phillips | Specialist/Technologist | 17 Cypress Creek Farm Rd, Sanford, NC 27332 | 2017-06-21 |
| 1033557012 | Krishawn Davis-darby | Student in an Organized Health Care Education/Training Program | 5593 Olivia Rd, Sanford, NC 27332 | 2013-06-12 |
| 1144593898 | Fetima Marie Wellington | Counselor | 310 Timberline Dr, Sanford, NC 27332 | 2012-02-10 |
| 1740588383 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1655 Buffalo Lake Road, Sanford, NC 27332 | 2011-03-07 |
| 1912057282 | Susan Kay Byerly | Psychologist | 226 E Trade St, Sanford, NC 27332 | 2007-01-11 |
| 1265503601 | David A Edrington Dds Pa | Dentist | 420 West Main Street, Sanford, NC 27332 | 2006-11-09 |
| 1396840625 | Knecht Chiropractic Center PC | Chiropractor | 2631 South Horner Boulevard, Sanford, NC 27332 | 2006-09-13 |
| 1861446338 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 310 Commerce Drive, Sanford, NC 27332 | 2006-05-20 |
| 1700863271 | Vincent Paul Vissichelli | Dentist | 73 Pineridge Cove, Sanford, NC 27332 | 2005-12-27 |
| 1992787832 | Tenet Central Carolina Physicians Inc | Internal Medicine | 4546 Hwy 87 S, Sanford, NC 27332 | 2005-11-16 |
| Find all providers in zip 27332 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
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| 1356470322 | Roger Dwight Thomas Sr. | Technician/Technologist | 2648 Lee Ave, Sanford, NC 27332-5950 | 2007-03-05 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.