Provider Demographics
NPI:1346585197
Name:GREENWOOD FAMILY EYE CARE INC.
Entity Type:Organization
Organization Name:GREENWOOD FAMILY EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZEPLIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:803-719-3119
Mailing Address - Street 1:508 BYPASS 72 NW
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-1300
Mailing Address - Country:US
Mailing Address - Phone:803-719-3119
Mailing Address - Fax:
Practice Address - Street 1:508 BYPASS 72 NW
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1300
Practice Address - Country:US
Practice Address - Phone:803-719-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1270152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD12706Medicaid
SCD12706Medicaid