Organization
EAST COAST OPTOMETRIC, INC
Active
Other names
H. Rubin Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONYA R NANCE (THIRD PARTY ADMINISTRATOR)
(803) 779-9313
Entity
Organization
Contact information
Practice address
901 BUSH RIVER RD, COLUMBIA, SC 29210
(803) 798-2290
(803) 731-5778
Mailing address
7539 GARNERS FERRY RD, COLUMBIA, SC 29209
(803) 779-9313
(803) 779-9551
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1028
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9957
—
SC
Enumeration date
11/01/2006
Last updated
10/12/2010
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