Organization
NINI S PATHEJA
Active
Other names
Aiken Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LADONNE C OCONNOR RHIT CCS (OFFICE MANAGER)
(803) 642-6060
Entity
Organization
Contact information
Practice address
110 PEPPER HILL WAY, AIKEN, SC 29801-2818
(803) 642-6060
(803) 642-0754
Mailing address
110 PEPPER HILL WAY, AIKEN, SC 29801-2818
(803) 642-6060
(803) 642-0754
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
21946
SC
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3927440001
MEDICARE SUPPLIER PROVIDER #
SC
05
—
DMO344
—
SC
Enumeration date
02/05/2007
Last updated
06/18/2008
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