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NPI Code Detail

MEDICARE: HEATHER WEST ABOC, NCLEC, LDO

MEDICARE: HEATHER WEST ABOC, NCLEC, LDO
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
1156FX1800XOptician1573SC

General Provider Information

NPI Number : 1215866728
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER WEST ABOC, NCLEC, LDO
Provider Business Mailing Address
First Line : 11410 ANDERSON RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29611-7502
Country : US
Telephone Number : 864-605-6321
Fax Number : 864-269-5745
Provider Business Practice Location Address
First Line : 11410 ANDERSON RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29611-7502
Country : US
Telephone Number : 864-605-6321
Fax Number : 864-269-5745
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2026
Last Update Date : 05/19/2026

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