Healthcare Provider Details

I. General information

NPI: 1376692590
Provider Name (Legal Business Name): SOUTH CAROLINA COMMISSION FOR THE BLIND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 CONFEDERATE AVE
COLUMBIA SC
29201-1914
US

IV. Provider business mailing address

PO BOX 2467
COLUMBIA SC
29202-2467
US

V. Phone/Fax

Practice location:
  • Phone: 803-898-8731
  • Fax:
Mailing address:
  • Phone: 803-898-8731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JUAN SIMS
Title or Position: CONTROLLER
Credential:
Phone: 803-898-7701