Organization
COASTAL OPTICAL INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL L. RATELIFF (OFFICE MANAGER)
(843) 546-0442
Entity
Organization
Contact information
Practice address
1200 HIGHMARKET ST, SUITE 200, GEORGETOWN, SC 29440-3227
(843) 546-0442
(843) 546-1173
Mailing address
1200 HIGHMARKET ST, SUITE 200, GEORGETOWN, SC 29440-3227
(843) 546-0442
(843) 546-1173
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9921
—
SC
Enumeration date
01/23/2007
Last updated
08/22/2020
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