MEDICARE: EYEWEAR BOUTIQUE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	561	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093960106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEWEAR BOUTIQUE INC

Provider Business Mailing Address
First Line	:	339 W MAIN ST
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-2366
Country	:	US
Telephone Number	:	843-374-2040
Fax Number	:	843-374-5131

Provider Business Practice Location Address
First Line	:	339 W MAIN ST
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-2366
Country	:	US
Telephone Number	:	843-374-2040
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. STEVE C HOBBS
Credential	:	OD
Telephone Number	:	843-374-2040

Provider Enumeration Date	:	11/18/2008
Last Update Date	:	11/18/2008

Similar Medicare Providers

1699825349 — ANDREA M BARROWS PHARMD
Practice Location Address:

1638 S 900 E
SALT LAKE CITY, UT
84105-2366

Practice Phone: 801-484-8782
Practice Fax:

1043543754 — ASSOCIATED FRESH MARKETS INC
Practice Location Address:

1638 S 9TH E
SALT LAKE CITY, UT
84105-2366

Practice Phone: 801-484-8742
Practice Fax: 801-463-1153

1053785386 — MR. SAMUEL CHASE WARNER PHARM D.
Practice Location Address:

1638 S 900 E
SALT LAKE CITY, UT
84105-2366

Practice Phone: 801-484-8782
Practice Fax:

1568421782 — MICHAEL JAMES KOTOWSKI D.D.S.
Practice Location Address:

515 MOORE RD
AVON LAKE, OH
44012-2366

Practice Phone: 440-933-5428
Practice Fax:

1306941380 — MEDICAL GROUP PHARMACY INC
Practice Location Address:

650 HAWKINS AVE
LAKE RONKONKOMA, NY
11779-2366

Practice Phone: 631-588-8582
Practice Fax: 631-588-8599

1578619391 — DR. ROGER BLANK O.D.
Practice Location Address:

603 CORTLAND DR
LAKE ZURICH, IL
60047-2366

Practice Phone: 847-975-1653
Practice Fax:

Directions to “EYEWEAR BOUTIQUE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.