Organization
SUMTER OPTICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN ELIZABETH GAY (BILLING)
(803) 905-8047
Entity
Organization
Contact information
Practice address
365 WEST WESMARK BLVD, SUMTER, SC 29150
(803) 905-8047
(803) 905-8047
Mailing address
365 WEST WESMARK BLVD, SUMTER, SC 29150
(803) 905-8047
(803) 905-8090
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
043168838
SC
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3423
—
SC
Enumeration date
01/09/2007
Last updated
03/04/2014
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