Provider Demographics
NPI:1013207737
Name:MCNAMARA EYE CARE LLC
Entity Type:Organization
Organization Name:MCNAMARA EYE CARE LLC
Other - Org Name:COOSAW EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-732-4107
Mailing Address - Street 1:8484 DORCHESTER RD
Mailing Address - Street 2:B-3
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7319
Mailing Address - Country:US
Mailing Address - Phone:843-767-2328
Mailing Address - Fax:
Practice Address - Street 1:8484 DORCHESTER RD
Practice Address - Street 2:B-3
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7319
Practice Address - Country:US
Practice Address - Phone:843-767-2328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1604261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center