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General NPI Number Information
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NPI Number | 1053664581
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Entity Type | Organization
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Legal Business Name | PRIDE EYECARE PA
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1220 EBENEZER RD
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City | ROCK HILL
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State | SC
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Zip | 29732-2341
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Country | US
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Telephone | 803-327-2020
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Fax | 803-327-2335
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Provider Business Mailing Address
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Address Line | 1220 EBENEZER RD
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City | ROCK HILL
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State | SC
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Zip | 29732-2341
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Country | US
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Telephone | 803-327-2020
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Fax | 803-327-2335
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM R. HUNDLEY
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Credential | O.D.
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Telephone | 803-327-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1135
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License Number State | SC
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