Provider Demographics
NPI:1831127471
Name:THE EYE CENTER PA
Entity Type:Organization
Organization Name:THE EYE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MILNE
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:803-256-0641
Mailing Address - Street 1:1655 BERNARDIN AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2039
Mailing Address - Country:US
Mailing Address - Phone:803-256-0641
Mailing Address - Fax:803-779-3649
Practice Address - Street 1:1655 BERNARDIN AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-2039
Practice Address - Country:US
Practice Address - Phone:803-256-0641
Practice Address - Fax:803-779-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA2755Medicaid
SC1793Medicare PIN
SC0327200001Medicare NSC