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NPI Code Detail

MEDICARE: STORY EYE, LLC

MEDICARE: STORY EYE, LLC
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
1332H00000XEyewear Supplier10512SC
2207W00000XOphthalmology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1326263658
Entity Type Code : Organization
Provider Name (Legal Business Name) : STORY EYE, LLC
Provider Business Mailing Address
First Line : 209 S WYLIE ST
Second Line :
City : LANCASTER
State : SC
Zip : 29720-2353
Country : US
Telephone Number : 803-285-7400
Fax Number : 803-285-7554
Provider Business Practice Location Address
First Line : 209 S WYLIE ST
Second Line :
City : LANCASTER
State : SC
Zip : 29720-2353
Country : US
Telephone Number : 803-285-7400
Fax Number : 803-285-7554
Authorized Official
Title or Position : OWNER MD
Name : JOHN W. STORY
Credential : M.D.
Telephone Number : 803-285-7400
Provider Enumeration Date : 04/13/2007
Last Update Date : 02/17/2012

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Directions to “STORY EYE, LLC ” Practice Location

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