Provider Demographics
NPI:1548344245
Name:W.C. ADAMS
Entity type:Organization
Organization Name:W.C. ADAMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-894-2001
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-0397
Mailing Address - Country:US
Mailing Address - Phone:919-894-2001
Mailing Address - Fax:919-894-3190
Practice Address - Street 1:304 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:NC
Practice Address - Zip Code:27504-1511
Practice Address - Country:US
Practice Address - Phone:919-894-2001
Practice Address - Fax:919-894-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1368152W00000X
NC1327152W00000X
NC770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890150QMedicaid
NC0150QOtherBCBS
NC0794680001Medicare NSC
NCCG1405Medicare PIN
NC0150QOtherBCBS