Organization
CAROLINA VISION ASSOCIATES, LLC
Active
Parent organization
CAROLINA VISION ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINA VISION ASSOCIATES, LLC
Authorized official
KIMBERLY WILLARD (PRACTICE ADMINISTRATOR)
(864) 583-3125
Entity
Organization
Contact information
Practice address
180 N. DEAN STREET, SPARTANBURG, SC 29302
(864) 583-3125
(864) 542-1367
Mailing address
180 N. DEAN STREET, SPARTANBURG, SC 29302
(864) 583-3125
(864) 542-1367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5514
MEDICARE GROUP NUMBER
SC
Enumeration date
05/27/2010
Last updated
04/11/2013
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