Provider Demographics
NPI:1275731036
Name:SAWYER OPTICIANS
Entity Type:Organization
Organization Name:SAWYER OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KOCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-256-8080
Mailing Address - Street 1:1516 GREGG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-256-8080
Mailing Address - Fax:803-779-9782
Practice Address - Street 1:1516 GREGG ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-256-8080
Practice Address - Fax:803-779-9782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
B91607Medicare UPIN
0703360001Medicare ID - Type Unspecified