Provider Demographics
NPI:1306016589
Name:BELLA EYE CARE INC
Entity Type:Organization
Organization Name:BELLA EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:PITCAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD,
Authorized Official - Phone:843-870-4073
Mailing Address - Street 1:983 SEA GULL DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4143
Mailing Address - Country:US
Mailing Address - Phone:843-870-4073
Mailing Address - Fax:
Practice Address - Street 1:730 COLEMAN BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4053
Practice Address - Country:US
Practice Address - Phone:843-870-4073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC1374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8928Medicare PIN