Provider Demographics
NPI:1164685921
Name:DOWN EAST EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DOWN EAST EYE ASSOCIATES, LLC
Other - Org Name:COASTAL NORTH VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:WESTERLUND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-325-7131
Mailing Address - Street 1:106 HARBOR OAKS DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-9364
Mailing Address - Country:US
Mailing Address - Phone:843-325-7131
Mailing Address - Fax:
Practice Address - Street 1:1516 HWY 17 N
Practice Address - Street 2:UNIT 5
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582
Practice Address - Country:US
Practice Address - Phone:843-325-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty