Provider Demographics
NPI:1326243924
Name:PALMETTO VISION CARE LLC
Entity Type:Organization
Organization Name:PALMETTO VISION CARE LLC
Other - Org Name:MOBILE EYE CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MORABITO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-573-9944
Mailing Address - Street 1:88 FOLLY ROAD BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7551
Mailing Address - Country:US
Mailing Address - Phone:843-573-9944
Mailing Address - Fax:843-573-9969
Practice Address - Street 1:88 FOLLY ROAD BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7551
Practice Address - Country:US
Practice Address - Phone:843-573-9944
Practice Address - Fax:843-573-9969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1261152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU952847884OtherINSTILL HEALTH INSURANCE
SC922OtherBLUE CHOICE HEALTH PLAN
SCE1473OtherMEDCOST
SC=========OtherCIGNA
SC=========OtherMANAGED MED
SCE1473OtherMEDCOST
SC922OtherBLUE CHOICE HEALTH PLAN
SC=========OtherUNITED HEALTH CARE
SC=========OtherBLUE CROSS BLUE SHIELD
SC=========OtherUNITED HEALTH CARE