Provider Demographics
NPI:1265667372
Name:INFINITY EYE CARE
Entity Type:Organization
Organization Name:INFINITY EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-795-6464
Mailing Address - Street 1:325 FOLLY RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2507
Mailing Address - Country:US
Mailing Address - Phone:843-795-6464
Mailing Address - Fax:843-795-6433
Practice Address - Street 1:325 FOLLY RD
Practice Address - Street 2:SUITE 109
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2507
Practice Address - Country:US
Practice Address - Phone:865-300-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1442152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9635Medicaid
SCDP5026OtherRR MEDICARE
SC6259010001Medicare NSC
SCDA9635Medicaid