Healthcare Provider Details

I. General information

NPI: 1831127471
Provider Name (Legal Business Name): THE EYE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 BERNARDIN AVENUE SUITE 100
COLUMBIA SC
29204-2039
US

IV. Provider business mailing address

1655 BERNARDIN AVENUE SUITE 100
COLUMBIA SC
29204-2039
US

V. Phone/Fax

Practice location:
  • Phone: 803-256-0641
  • Fax: 803-779-3649
Mailing address:
  • Phone: 803-256-0641
  • Fax: 803-779-3649

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: HENRY L MILNE III
Title or Position: MEDICAL DIRECTOR PRESIDENT
Credential: MD
Phone: 803-256-0641