Organization
EYE ASSOCIATES OF LITTLE RIVER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON L. DIAMOND O.D. (OPTOMETRIST)
(843) 333-5435
Entity
Organization
Contact information
Practice address
4000 HIGHWAY 9 E, SUITE 260, LITTLE RIVER, SC 29566-7833
(843) 390-0058
(843) 390-0999
Mailing address
4000 HIGHWAY 9 E, SUITE 260, LITTLE RIVER, SC 29566-7833
(843) 390-0058
(843) 390-0999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1408
SC
152W00000X
Optometrist
1409
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9678
—
SC
01
—
DN6087
RAILROAD MEDICARE
SC
Enumeration date
06/11/2006
Last updated
11/07/2008
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