Provider Demographics
NPI:1952061475
Name:EMERALD CITY EYE CARE LLC
Entity Type:Organization
Organization Name:EMERALD CITY EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:864-680-3037
Mailing Address - Street 1:853 BYPASS 72 NW
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-1203
Mailing Address - Country:US
Mailing Address - Phone:864-302-0202
Mailing Address - Fax:864-302-0204
Practice Address - Street 1:853 BYPASS 72 NW
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1203
Practice Address - Country:US
Practice Address - Phone:864-302-0202
Practice Address - Fax:864-302-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty