Provider Demographics
NPI:1518328368
Name:EYE COOPERATIVE
Entity Type:Organization
Organization Name:EYE COOPERATIVE
Other - Org Name:ST ANDREWS COMMUNITY DEVELOPMENT CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENGI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGAHEE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:803-661-2074
Mailing Address - Street 1:P O BOX 3183
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-661-2074
Mailing Address - Fax:803-636-8993
Practice Address - Street 1:7821 ST ANDREWS ROAD
Practice Address - Street 2:#3183
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063
Practice Address - Country:US
Practice Address - Phone:803-661-2074
Practice Address - Fax:803-636-8993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable