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General NPI Number Information
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NPI Number | 1184686792
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Entity Type | Organization
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Legal Business Name | COLUMBIA EYE SURG CENTER INC
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1920 PICKENS ST
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City | COLUMBIA
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State | SC
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Zip | 29201-2632
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Country | US
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Telephone | 803-779-3070
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Fax | 803-771-7639
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Provider Business Mailing Address
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Address Line | PO BOX 60251
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City | CHARLOTTE
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State | NC
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Zip | 28260-0251
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Country | US
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Telephone | 803-779-3070
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Fax | 803-771-7639
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Authorized Official
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Title or Position | NURSING DIRECTOR, MANAGER
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Name | JOSE A RODRIGUEZ
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Credential | APRN
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Telephone | 803-254-7732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | ASF018
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License Number State | SC
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