Provider Demographics
NPI:1598984718
Name:VISIOIN CARE P.A.
Entity Type:Organization
Organization Name:VISIOIN CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:842-839-0504
Mailing Address - Street 1:1240 21 AVENUE NORTH
Mailing Address - Street 2:SUITE1A
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577
Mailing Address - Country:US
Mailing Address - Phone:843-839-0504
Mailing Address - Fax:843-423-1971
Practice Address - Street 1:1240 21 AVENUE NORTH
Practice Address - Street 2:SUITE1A
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577
Practice Address - Country:US
Practice Address - Phone:843-839-0504
Practice Address - Fax:843-423-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
789152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty