Provider Demographics
NPI:1679046569
Name:EYE CARE ASSOCIATES OF SC LLC
Entity type:Organization
Organization Name:EYE CARE ASSOCIATES OF SC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSNES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:866-523-7999
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-0880
Mailing Address - Country:US
Mailing Address - Phone:803-906-9993
Mailing Address - Fax:
Practice Address - Street 1:206 E 2ND NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6858
Practice Address - Country:US
Practice Address - Phone:843-851-1037
Practice Address - Fax:843-851-1392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty