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General NPI Number Information
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NPI Number | 1962774117
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Entity Type | Organization
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Legal Business Name | APEX EYECARE LLC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 7499 PARKLANE RD SUITE 160
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City | COLUMBIA
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State | SC
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Zip | 29223-7650
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Country | US
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Telephone | 803-622-2058
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Fax | 803-781-0681
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Provider Business Mailing Address
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Address Line | 133 SILVER LAKE CIR
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City | COLUMBIA
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State | SC
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Zip | 29212-2428
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Country | US
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Telephone | 803-622-2058
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Fax | 803-781-0681
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL C MCCLAY
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Credential | OD
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Telephone | 803-622-2058
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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 | 579
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License Number State | SC
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