MEDICARE: INLET OPTOMETRIC EYCARE, INC.

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	152W00000X	Optometrist	1324	SC

General Provider Information

NPI Number	:	1972717940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INLET OPTOMETRIC EYCARE, INC.

Provider Business Mailing Address
First Line	:	4343 CROSS CUT TRL
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6904
Country	:	US
Telephone Number	:	843-215-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	3013 NEWCASTLE LOOP
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-4502
Country	:	US
Telephone Number	:	843-215-3000
Fax Number	:	843-215-5310

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. JOHN MICHAEL MILLS
Credential	:	O.D.
Telephone Number	:	843-215-5300

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	06/12/2023

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