MEDICARE: CAROLINA RETINA CENTER 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
1	207W00000X	Ophthalmology Physician
2	207WX0107X	Retina Specialist (Ophthalmology) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205892783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINA RETINA CENTER P.A.

Provider Business Mailing Address
First Line	:	7620 TRENHOLM ROAD EXT
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1718
Country	:	US
Telephone Number	:	803-736-7200
Fax Number	:	803-736-2116

Provider Business Practice Location Address
First Line	:	7620 TRENHOLM ROAD EXT
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29223-1718
Country	:	US
Telephone Number	:	803-736-7200
Fax Number	:	803-736-2116

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY GLENN GROSS
Credential	:	M.D.
Telephone Number	:	803-736-7200

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	08/04/2017

Similar Medicare Providers

1427059351 — JEFFREY GLENN GROSS M.D.
Practice Location Address:

7620 TRENHOLM ROAD EXT
COLUMBIA, SC
29223-1718

Practice Phone: 803-736-7200
Practice Fax: 803-736-2116

1316948243 — BARRON CRAWFORD FISHBURNE M.D.
Practice Location Address:

7620 TRENHOLM ROAD EXT
COLUMBIA, SC
29223-1718

Practice Phone: 803-736-7200
Practice Fax: 803-736-2116

1043636764 — BRANDON S YOUNG DPT, PT
Practice Location Address:

1718 SAINT JULIAN PL
COLUMBIA, SC
29204-2410

Practice Phone: 803-771-0370
Practice Fax: 803-771-0371

1275953721 — KATHRYN CORINNE NEWSOM PT, DPT
Practice Location Address:

1718 SAINT JULIAN PL
COLUMBIA, SC
29204-2410

Practice Phone: 38-771-0370
Practice Fax: 803-771-0371

1447826292 — MEREDITH ASHTON MILES PT
Practice Location Address:

1718 SAINT JULIAN PL
COLUMBIA, SC
29204-2410

Practice Phone: 803-771-0370
Practice Fax: 803-771-0371

1699473389 — EMILY OLIVIA NORDBERG DPT
Practice Location Address:

1718 SAINT JULIAN PL
COLUMBIA, SC
29204-2410

Practice Phone: 803-771-0370
Practice Fax: 803-771-0371

Directions to “CAROLINA RETINA CENTER P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.