Provider Demographics
NPI:1578748901
Name:RHODES OPTICIANS INC.
Entity Type:Organization
Organization Name:RHODES OPTICIANS INC.
Other - Org Name:JIMMY RHODES OPTICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:843-665-1100
Mailing Address - Street 1:1955 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6173
Mailing Address - Country:US
Mailing Address - Phone:843-665-1100
Mailing Address - Fax:
Practice Address - Street 1:1955 2ND LOOP RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6173
Practice Address - Country:US
Practice Address - Phone:843-665-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC292332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0623200001Medicare NSC