Healthcare Provider Details
I. General information
NPI: 1366487787
Provider Name (Legal Business Name): FOLLINE OPTICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/19/2006
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1670 SPRINGDALE DRIVE SPRINGDALE SHOPPING CENTER UNIT 6
CAMDEN SC
29020
US
IV. Provider business mailing address
PO BOX 5721
COLUMBIA SC
29250
US
V. Phone/Fax
- Phone: 803-432-2573
- Fax: 803-432-4618
- Phone: 803-799-8168
- Fax: 803-799-0854
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
EMILY
FOLLINE
MIKELL
Title or Position: ITS VICE PRESIDENT
Credential:
Phone: 803-799-8168