Individual
BENJAMIN C POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
121 BETHEL ST, CLOVER, SC 29710-1101
(803) 222-9538
(803) 222-1898
Mailing address
121 BETHEL ST, CLOVER, SC 29710-1101
(803) 222-9538
(803) 222-1898
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
NC1109
NC
152W00000X
Optometrist
Primary
SC 728
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09655
BCBS OF NC
NC
01
—
570788101001
BCBS OF SC
SC
05
—
89-09655
—
NC
05
—
D07286
—
SC
Enumeration date
04/26/2006
Last updated
05/19/2016
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