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Organization
CAROLINA CATARACT AND VISION CENTER
Active
Organization
CAROLINA CATARACT AND VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CANDICE DAVIS (CHIEF REVENUE CYCLE OFFICER)
(916) 990-7590
Entity
Organization
Contact information
Practice address
137 GATEWAY DRIVE, LADSON, SC 29456-3552
(843) 797-3676
(843) 797-3677
Mailing address
PO BOX 279, LADSON, SC 29456-0279
(843) 797-3676
(843) 797-3677
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
18651
SC
207W00000X
Ophthalmology Physician
Primary
21896
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073562492
INDIVIDUAL NPI
SC
01
—
1750393138
INDIVIDUAL NPI
SC
05
—
1D218963
—
SC
01
—
P00371766
RAILROAD MEDICARE
SC
Enumeration date
02/27/2008
Last updated
11/17/2023
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