Provider Demographics
NPI:1639332075
Name:DANIEL REAMES OPTOMETRY, LLC
Entity Type:Organization
Organization Name:DANIEL REAMES OPTOMETRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:REAMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-413-1448
Mailing Address - Street 1:15 DEALLYON AVE
Mailing Address - Street 2:APT 89
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29928-7009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:149 RIVERWALK BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-8190
Practice Address - Country:US
Practice Address - Phone:843-379-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1525152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9039Medicare PIN