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NPI Code Detail

MEDICARE: PALMETTO EYECARE ASSOCIATES P A

MEDICARE: PALMETTO EYECARE ASSOCIATES P A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1134364128
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALMETTO EYECARE ASSOCIATES P A
Provider Business Mailing Address
First Line : 2460 INDIA HOOK RD
Second Line : SUITE 206
City : ROCK HILL
State : SC
Zip : 29732-3530
Country : US
Telephone Number : 803-985-2020
Fax Number : 803-985-2021
Provider Business Practice Location Address
First Line : 2460 INDIA HOOK RD
Second Line : SUITE 206
City : ROCK HILL
State : SC
Zip : 29732-3530
Country : US
Telephone Number : 803-985-2020
Fax Number : 803-985-2021
Authorized Official
Title or Position : PRESIDENT
Name : PAUL BURT
Credential : O.D.
Telephone Number : 803-985-2020
Provider Enumeration Date : 12/05/2008
Last Update Date : 04/23/2013

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Directions to “PALMETTO EYECARE ASSOCIATES P A ” Practice Location

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