Provider Demographics
NPI:1174773535
Name:EYE CONCEPTS, LLC
Entity type:Organization
Organization Name:EYE CONCEPTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KISHINCHAND
Authorized Official - Middle Name:G
Authorized Official - Last Name:GOPANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-736-5818
Mailing Address - Street 1:209 BIG LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-9412
Mailing Address - Country:US
Mailing Address - Phone:803-736-5818
Mailing Address - Fax:
Practice Address - Street 1:331 KILLIAN RD STE B2
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8926
Practice Address - Country:US
Practice Address - Phone:803-760-2430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier