Provider Demographics
NPI:1992145015
Name:PREMIER EYE CARE O.D., P.A.
Entity type:Organization
Organization Name:PREMIER EYE CARE O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-629-3794
Mailing Address - Street 1:250 DAVIS PLANTATION RD
Mailing Address - Street 2:
Mailing Address - City:BESSEMER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28016-8532
Mailing Address - Country:US
Mailing Address - Phone:704-629-3794
Mailing Address - Fax:
Practice Address - Street 1:705 E DIXON BLVD
Practice Address - Street 2:WALMART VISION CENTER #1034
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6821
Practice Address - Country:US
Practice Address - Phone:704-487-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty