Healthcare Provider Details
I. General information
NPI: 1679046569
Provider Name (Legal Business Name): EYE CARE ASSOCIATES OF SC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/03/2019
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506-A OLD LEXINGTON HWY
CHAPIN SC
29036
US
IV. Provider business mailing address
PO BOX 880
FORT WASHINGTON PA
19034-0880
US
V. Phone/Fax
- Phone: 843-851-1037
- Fax: 843-851-1392
- Phone: 803-906-9993
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUSSELL
OSNES
Title or Position: OWNER
Credential: OD
Phone: 866-523-7999