# PVBLUFFTON

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

## Provider details

- **NPI number:** 1962820050
- **Authorized official:** NICHOLAS BOLLIN (OWNER)
- **Authorized official phone:** (304) 382-2542

## Contact information

- **Practice address:** 3 MALPHRUS RD STE 101, BLUFFTON, SC 29910-6635
- **Practice address phone:** (843) 837-9222
- **Mailing address:** 3 MALPHRUS RD STE 101, BLUFFTON, SC 29910-6635
- **Mailing address phone:** (843) 837-9222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332H00000X | Eyewear Supplier | 15029 | SC | Yes |

## Other

- **Enumeration date:** 04/04/2014
- **Last updated:** 04/04/2014