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General NPI Number Information
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NPI Number | 1619158771
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Entity Type | Organization
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Legal Business Name | ADAMS OPTICAL DBA HOLLY HILL EYE CLINIC
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 190 RENTAL DR.
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City | HOLLY HILL
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State | SC
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Zip | 29059
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Country | US
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Telephone | 803-496-5261
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Fax | 803-496-5261
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Provider Business Mailing Address
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Address Line | PO BOX 1030
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City | HOLLY HILL
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State | SC
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Zip | 29059-1030
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Country | US
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Telephone | 803-496-5261
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Fax | 803-496-5261
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAY L. ADAMS
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Credential | O.D.
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Telephone | 803-496-5261
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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 | 479
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License Number State | SC
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