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General NPI Number Information
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NPI Number | 1881305852
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Entity Type | Organization
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Legal Business Name | EYE GUYS CAROLINA LLC
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Dates
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Enumeration Date | 12/09/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 792 SILVER BLUFF RD
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City | AIKEN
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State | SC
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Zip | 29803-6055
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Country | US
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Telephone | 803-642-9902
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Fax |
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Provider Business Mailing Address
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Address Line | 792 SILVER BLUFF RD
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City | AIKEN
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State | SC
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Zip | 29803-6055
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Country | US
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Telephone | 803-642-9902
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CHRISTINA MCFATRIDGE
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Credential |
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Telephone | 706-651-2020
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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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