| Active Life Eye Care, Od, Pa | |
|
415 W Academy St, Madison, NC 27025-2005 | |
| (336) 404-6235 | |
| Not Available |
| Full Name | Active Life Eye Care, Od, Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 415 W Academy St, Madison, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740663855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Brent B Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235239641 PECOS PAC ID: 0446226476 Enrollment ID: I20160112001715 |
| Mailing Address | Practice Location Address |
|---|---|
| Active Life Eye Care, Od, Pa 415 W Academy St, Madison, NC 27025-2005 Ph: (336) 404-6235 | Active Life Eye Care, Od, Pa 415 W Academy St, Madison, NC 27025-2005 Ph: (336) 404-6235 |
Dr. Brent Bundy Johnson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 714 Highway St, Madison, NC 27025 Phone: 336-427-2020 Fax: 336-427-2022 | |
Dr. Truc Ly Nguyen Tran, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 714 Highway St, Madison, NC 27025 Phone: 336-427-2020 | |
Myeyedr Optometry Of North Carolina Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 714 N Highway St, Madison, NC 27025 Phone: 336-427-2020 Fax: 336-427-2022 |