Organization
SPECIALTY EYE CARE OF THE CAROLINAS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN F. RILEY MD (PRESIDENT)
(910) 754-5434
Entity
Organization
Contact information
Practice address
15 MEDICAL CENTER DR, SUPPLY, NC 28462-3350
(910) 754-5437
(910) 754-5443
Mailing address
1115 48TH AVE N STE 121, MYRTLE BEACH, SC 29577-5420
(843) 449-6478
(843) 497-8571
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9300575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137Y
BCBS
NC
05
—
891137Y
—
NC
Enumeration date
10/31/2007
Last updated
10/31/2007
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