Healthcare Provider Details

I. General information

NPI: 1033565643
Provider Name (Legal Business Name): JAMES-OLIVEREYECARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N CONGRESS ST
YORK SC
29745-1529
US

IV. Provider business mailing address

46 N CONGRESS ST
YORK SC
29745-1529
US

V. Phone/Fax

Practice location:
  • Phone: 803-628-5477
  • Fax: 803-628-5474
Mailing address:
  • Phone: 803-628-5477
  • Fax: 803-628-5474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1477
License Number StateSC

VIII. Authorized Official

Name: DR. ALEQUE STEGALL JAMES
Title or Position: OWNER
Credential: OD
Phone: 803-628-5477