Provider Demographics
NPI:1821266768
Name:WRIGHT EYE INSTITUTE, INC.
Entity Type:Organization
Organization Name:WRIGHT EYE INSTITUTE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-539-2020
Mailing Address - Street 1:1697 AMELIA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-6073
Mailing Address - Country:US
Mailing Address - Phone:803-539-2020
Mailing Address - Fax:803-539-3937
Practice Address - Street 1:1697 AMELIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-6073
Practice Address - Country:US
Practice Address - Phone:803-539-2020
Practice Address - Fax:803-539-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9839Medicaid
SCU648260281Medicare UPIN