Provider Demographics
NPI:1861525057
Name:PRICE, PAMELA CATHY (OD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:CATHY
Last Name:PRICE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7749 MATTHEWS MINT HILL RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7598
Mailing Address - Country:US
Mailing Address - Phone:704-545-9797
Mailing Address - Fax:704-545-3111
Practice Address - Street 1:7749 MATTHEWS MINT HILL RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7598
Practice Address - Country:US
Practice Address - Phone:704-545-9797
Practice Address - Fax:704-545-3111
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC970152WC0802X
NC0970152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU11685Medicare UPIN