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General NPI Number Information
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NPI Number | 1245384726
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Entity Type | Organization
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Legal Business Name | PALMETTO EYECARE, P.A.
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 1001 S MAIN ST
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City | GREENWOOD
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State | SC
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Zip | 29646-3230
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Country | US
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Telephone | 864-388-2020
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Fax | 864-229-5573
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Provider Business Mailing Address
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Address Line | 1001 MAIN ST S
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City | GREENWOOD
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State | SC
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Zip | 29646-3230
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Country | US
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Telephone | 864-388-2020
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Fax | 864-229-5573
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH MACK NASH
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Credential | OD
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Telephone | 864-388-2020
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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 | 553
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License Number State | SC
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