Provider Demographics
NPI:1043427776
Name:DRS EYECARE, INC.
Entity Type:Organization
Organization Name:DRS EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-741-2010
Mailing Address - Street 1:620 GERVAIS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3048
Mailing Address - Country:US
Mailing Address - Phone:803-779-1001
Mailing Address - Fax:803-779-1089
Practice Address - Street 1:620 GERVAIS ST
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3048
Practice Address - Country:US
Practice Address - Phone:803-779-1001
Practice Address - Fax:803-779-1089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTACT LENS CLINIC OF SC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9953Medicaid
SC1381Medicare PIN
SCDA9953Medicaid