Provider Demographics
NPI:1487624425
Name:EYEBRIDGE CONSULTING ASSOCIATES ODPA
Entity type:Organization
Organization Name:EYEBRIDGE CONSULTING ASSOCIATES ODPA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOSCHEIT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-616-8262
Mailing Address - Street 1:102 HIDDEN PASTURES DR STE 207
Mailing Address - Street 2:
Mailing Address - City:CRAMERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28032-1698
Mailing Address - Country:US
Mailing Address - Phone:704-616-8262
Mailing Address - Fax:
Practice Address - Street 1:201 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-2805
Practice Address - Country:US
Practice Address - Phone:704-425-2020
Practice Address - Fax:704-435-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902267Medicaid
NCDG2296OtherRAILROAD MEDICARE
NC018KEOtherBCBSNC
NCDG2296OtherRAILROAD MEDICARE
NC4673040001Medicare NSC