Organization
MONTAGUE EYE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER R LIPPENS OD (OWNER)
(864) 229-2301
Entity
Organization
Contact information
Practice address
711 MONTAGUE AVE, GREENWOOD, SC 29649
(864) 229-2301
(864) 229-1898
Mailing address
711 MONTAGUE AVE, PO BOX 1206, GREENWOOD, SC 29649
(864) 229-2301
(864) 229-1898
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1280
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9714
—
SC
01
—
DB0813
RAILROAD MEDICARE GROUP#
SC
Enumeration date
05/04/2007
Last updated
12/18/2007
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