Premier Family Eye Care Od PLLC
NPI 1063739274ActiveOrganization· Optometrist· Indian Trail, NC
Optometrist in Indian Trail, North Carolina, registered in NPPES in April 2010. The authorized official on file is Timothy Mack, OD, Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063739274 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 27, 2010 |
| Last updated in NPPES | Jan 4, 2024 |
| Certified by provider | Jan 4, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 2021 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
Other optometrists in Indian Trail
- 1083657639
- 1639878226
- 1932932076
- 1780455709
- 1811946460
- 1821702077
- 1902395783