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General NPI Number Information
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NPI Number | 1669037974
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Entity Type | Organization
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Legal Business Name | MEYE VISION CARE AND EYEWARE
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Dates
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Enumeration Date | 05/02/2019
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Last Update Date | 05/24/2019
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Provider Practice Location Address
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Address Line | 634 FRESHFIELDS DRIVE
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City | JOHNS ISLAND
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State | SC
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Zip | 29455
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Country | US
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Telephone | 843-768-0565
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Fax | 843-768-0566
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Provider Business Mailing Address
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Address Line | 634 FRESHFIELDS DRIVE
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City | JOHNS ISLAND
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State | SC
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Zip | 29455
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Country | US
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Telephone | 843-768-0565
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Fax | 843-768-0566
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DEREK SCOTT MAROUN
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Credential | OD
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Telephone | 843-768-0565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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