# CAROLINA RETINA CENTER P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205892783
- **Authorized official:** DR. JEFFREY GLENN GROSS M.D. (PRESIDENT)
- **Authorized official phone:** (803) 736-7200

## Contact information

- **Practice address:** 7620 TRENHOLM ROAD EXT, COLUMBIA, SC 29223-1718
- **Practice address phone:** (803) 736-7200
- **Practice address fax:** (803) 736-2116
- **Mailing address:** 7620 TRENHOLM ROAD EXT, COLUMBIA, SC 29223-1718
- **Mailing address phone:** (803) 736-7200
- **Mailing address fax:** (803) 736-2116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 08/04/2017