Provider Demographics
NPI:1861741639
Name:EDNEY EYE ASSOCIATES OD
Entity type:Organization
Organization Name:EDNEY EYE ASSOCIATES OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:VANCE
Authorized Official - Last Name:EDNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-894-3930
Mailing Address - Street 1:69 SHUFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-7406
Mailing Address - Country:US
Mailing Address - Phone:828-894-3930
Mailing Address - Fax:828-894-3950
Practice Address - Street 1:69 SHUFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-7406
Practice Address - Country:US
Practice Address - Phone:828-894-3930
Practice Address - Fax:828-894-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1256152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC246536CMedicare PIN