Provider Demographics
NPI:1780823260
Name:EYE CARE SPECIALTIES GROUP - JAMES ISLAND
Entity Type:Organization
Organization Name:EYE CARE SPECIALTIES GROUP - JAMES ISLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MORABITO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-557-2865
Mailing Address - Street 1:776 DANIEL ELLIS DR
Mailing Address - Street 2:UNIT 3B
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3094
Mailing Address - Country:US
Mailing Address - Phone:843-573-9944
Mailing Address - Fax:
Practice Address - Street 1:776 DANIEL ELLIS DR
Practice Address - Street 2:UNIT 3B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3094
Practice Address - Country:US
Practice Address - Phone:843-573-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE CARE SPECIALTIES GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty