Healthcare Provider Details

I. General information

NPI: 1720796451
Provider Name (Legal Business Name): HORIZON EYE CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2022
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date: 01/13/2023
Reactivation Date: 03/10/2023

III. Provider practice location address

410 HERLONG AVE S STE 103
ROCK HILL SC
29732-8350
US

IV. Provider business mailing address

PO BOX 60160
CHARLOTTE NC
28260-0160
US

V. Phone/Fax

Practice location:
  • Phone: 803-818-9200
  • Fax: 803-818-9188
Mailing address:
  • Phone: 704-365-0555
  • Fax: 704-367-8122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. VICKY SESSOMS HARMON
Title or Position: MANAGED CARE COORDINATOR
Credential:
Phone: 704-405-4183