| |
310 Parler Avenue, St. George, SC 29477 | |
(843) 563-4546 | |
(803) 534-2180 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 310 Parler Avenue, St. George, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972781235 | NPI | - | NPPES |
D05591 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 00559 (South Carolina) | Secondary |
152W00000X | Optometrist | 559 (South Carolina) | Primary |
Mailing Address | Practice Location Address |
---|---|
1605 Carolina Avenue, Orangeburg, SC 29115-4939 Ph: (803) 534-2352 | 310 Parler Avenue, St. George, SC 29477 Ph: (843) 563-4546 |