Provider Demographics
NPI:1063631232
Name:CARYN M WEST & ASSOC PC
Entity Type:Organization
Organization Name:CARYN M WEST & ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARYN
Authorized Official - Middle Name:MCNANEY
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-775-9314
Mailing Address - Street 1:211 NORTH WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4204
Mailing Address - Country:US
Mailing Address - Phone:803-775-9314
Mailing Address - Fax:803-773-8381
Practice Address - Street 1:211 NORTH WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4204
Practice Address - Country:US
Practice Address - Phone:803-775-9314
Practice Address - Fax:803-773-8381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC0890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9846Medicaid
SC5839Medicare PIN
SCU02299Medicare UPIN
410047050Medicare PIN
SC4791350001Medicare NSC