| Indigo Vision Center Pa | |
|
302 Church St, Georgetown, SC 29440-2406 | |
| (843) 546-2244 | |
| (843) 546-2255 |
| Full Name | Indigo Vision Center Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 302 Church St, Georgetown, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700071149 | NPI | - | NPPES |
| D12791 | Medicaid | SC | |
| P00151729 | Other | SC | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1279 (South Carolina) | Primary |
| Provider Name | Owen Cannon Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346292059 PECOS PAC ID: 9931094828 Enrollment ID: I20040219000166 |
| Provider Name | Michelle West Nagro |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104497981 PECOS PAC ID: 6800291535 Enrollment ID: I20210818003739 |
| Mailing Address | Practice Location Address |
|---|---|
| Indigo Vision Center Pa 302 Church St, Georgetown, SC 29440-2406 Ph: (843) 546-2244 | Indigo Vision Center Pa 302 Church St, Georgetown, SC 29440-2406 Ph: (843) 546-2244 |
Tammy T. Tully Od Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1310 N Fraser St, Georgetown, SC 29440 Phone: 843-520-0576 Fax: 843-520-4398 | |
Tidewater Vision Center Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1175 N Fraser St, Georgetown, SC 29440 Phone: 843-527-2682 Fax: 843-527-2721 | |
Dr. Michelle West Nagro, OD Optometrist Medicare: Medicare Enrolled Practice Location: 302 Church St, Georgetown, SC 29440 Phone: 843-546-2244 | |
Walter A. Mayo, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1200 Highmarket St, Suite 200, Georgetown, SC 29440 Phone: 843-546-8421 Fax: 843-546-1173 | |
Ltc Eyecare Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 511 Prince St, Georgetown, SC 29440 Phone: 843-527-8020 Fax: 843-546-4111 | |
Dr. Owen Cannon Johnson, O.D. Optometrist Medicare: May Accept Medicare Assignments Practice Location: 302 Church St, A, Georgetown, SC 29440 Phone: 843-546-2244 Fax: 843-546-2255 | |
Crystal L. Franklin, Od, Pa Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1310 N Fraser St, Georgetown, SC 29440 Phone: 843-520-0576 |