Provider Demographics
NPI:1306022850
Name:CRAIG P MURTHA
Entity Type:Organization
Organization Name:CRAIG P MURTHA
Other - Org Name:EYEDESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURTHA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-366-6111
Mailing Address - Street 1:2368 CHERRY RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2165
Mailing Address - Country:US
Mailing Address - Phone:803-366-6111
Mailing Address - Fax:803-366-6544
Practice Address - Street 1:2368 CHERRY RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2165
Practice Address - Country:US
Practice Address - Phone:803-366-6111
Practice Address - Fax:803-366-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC781332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0617420001Medicare NSC