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730 West Church St, Bishopville, SC 29010 | |
(803) 484-5494 | |
(803) 484-5495 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 730 West Church St, Bishopville, 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 |
---|---|---|---|
1104018993 | NPI | - | NPPES |
DA9978 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Jason C Lee |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1245227321 PECOS PAC ID: 8729992110 Enrollment ID: I20031119000171 |
Provider Name | David Martin Andrews |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1669465084 PECOS PAC ID: 7719891118 Enrollment ID: I20031119000232 |
Mailing Address | Practice Location Address |
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730 West Church St, Bishopville, SC 29010-0815 Ph: (803) 484-5494 | 730 West Church St, Bishopville, SC 29010 Ph: (803) 484-5494 |