Healthcare Provider Details

I. General information

NPI: 1063597318
Provider Name (Legal Business Name): CENTER FOR SIGHT, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 WATERLOO ST SW
AIKEN SC
29801-3756
US

IV. Provider business mailing address

139 WATERLOO ST SW PO BOX 2171
AIKEN SC
29801-3756
US

V. Phone/Fax

Practice location:
  • Phone: 803-642-1000
  • Fax: 803-642-0036
Mailing address:
  • Phone: 803-642-1000
  • Fax: 803-642-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: RICHARD LEE GRANTHAM
Title or Position: PRESIDENT
Credential: MD
Phone: 803-642-1000