Organization
CAROLINA GLAUCOMA AND VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALRIC CHRISTOPHER BLAKE M.D. (OWNER)
(803) 779-4144
Entity
Organization
Contact information
Practice address
1 RICHLAND MEDICAL PARK DR, SUITE 210, COLUMBIA, SC 29203-6834
(803) 789-4144
(803) 779-4146
Mailing address
1 RICHLAND MEDICAL PARK DR, SUITE 210, COLUMBIA, SC 29203-6834
(803) 789-4144
(803) 779-4146
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17330
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180026568
RAILROAD MEDICARE
SC
05
—
GP1498
—
SC
Enumeration date
01/25/2007
Last updated
09/09/2009
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