Provider Demographics
NPI:1972870624
Name:SIMPSONVILLE EYE CARE LLC
Entity Type:Organization
Organization Name:SIMPSONVILLE EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-399-4714
Mailing Address - Street 1:3950 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-3163
Mailing Address - Country:US
Mailing Address - Phone:864-963-7213
Mailing Address - Fax:864-963-7319
Practice Address - Street 1:3950 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-3163
Practice Address - Country:US
Practice Address - Phone:864-963-7213
Practice Address - Fax:864-963-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty