# NINI S PATHEJA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aiken Optical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477692820
- **Authorized official:** MRS. LADONNE C OCONNOR RHIT CCS (OFFICE MANAGER)
- **Authorized official phone:** (803) 642-6060

## Contact information

- **Practice address:** 110 PEPPER HILL WAY, AIKEN, SC 29801-2818
- **Practice address phone:** (803) 642-6060
- **Practice address fax:** (803) 642-0754
- **Mailing address:** 110 PEPPER HILL WAY, AIKEN, SC 29801-2818
- **Mailing address phone:** (803) 642-6060
- **Mailing address fax:** (803) 642-0754

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 21946 | SC | — |
| 332H00000X | Eyewear Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 02/05/2007
- **Last updated:** 06/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3927440001 | MEDICARE SUPPLIER PROVIDER \# | SC |
| 05 | — | DMO344 | — | SC |