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General NPI Number Information
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NPI Number | 1790706927
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Entity Type | Organization
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Legal Business Name | CAROLINA EYECARE PHYSICIANS, LLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 459 SPRUCE ST
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City | WALTERBORO
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State | SC
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Zip | 29488-2766
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Country | US
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Telephone | 843-549-9500
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Fax | 843-549-6885
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Provider Business Mailing Address
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Address Line | 2861 TRICOM ST
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City | N CHARLESTON
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State | SC
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Zip | 29406-9172
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Country | US
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Telephone | 843-797-5511
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Fax | 843-797-0638
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DANIEL FLYNN
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Credential |
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Telephone | 843-725-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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