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General NPI Number Information
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NPI Number | 1972712008
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Entity Type | Organization
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Legal Business Name | SENECA OPTICIANS INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1598 SANDIFER BLVD SUITE J
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City | SENECA
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State | SC
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Zip | 29678-0929
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Country | US
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Telephone | 864-882-3255
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Fax | 864-882-3591
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Provider Business Mailing Address
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Address Line | 1598 SANDIFER BLVD SUITE J
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City | SENECA
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State | SC
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Zip | 29678-0929
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Country | US
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Telephone | 864-882-3255
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Fax | 864-882-3591
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Authorized Official
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Title or Position | OPTICIAN
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Name | MRS. LAURA MEADE HEATON
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Credential | LDO LICENSED DISPENS
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Telephone | 864-882-3255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 739
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License Number State | SC
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