Provider Demographics
NPI:1063599199
Name:FLAT ROCK OPTICIANS, LLC
Entity type:Organization
Organization Name:FLAT ROCK OPTICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN, HIS
Authorized Official - Phone:828-692-1320
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:EAST FLAT ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28726-0145
Mailing Address - Country:US
Mailing Address - Phone:828-692-1320
Mailing Address - Fax:828-693-3721
Practice Address - Street 1:1630 SPARTANBURG HWY
Practice Address - Street 2:SUITE B
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-6457
Practice Address - Country:US
Practice Address - Phone:828-692-1320
Practice Address - Fax:828-693-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332S00000X
NC1361332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5826600001Medicare NSC