Tega Cay Eye Care, LLC
Organization Active NPI Optometrist · Tega Cay, SC
NPI 1043482722 · NPPES record last updated Feb 20, 2013
Key facts
- NPI
- 1043482722
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1468 (SC)
- Legal business name
- TEGA CAY EYE CARE, LLC
- Practice address
- 1151 Stonecrest Blvd
Tega Cay, SC 29708 - Phone
- (803) 802-4733
- Fax
- (803) 802-4735
- NPI assigned
- Apr 2, 2008
- Organization subpart
- No
Authorized official
- Name
- Larry F Jerge, OD
- Title
- Optometrist Owner
- Phone
- (803) 802-4733
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1468 | SC | Yes |
Addresses
Primary practice location
1151 Stonecrest Blvd
Tega Cay, SC 29708
Mailing address
600 Pine Links Dr
Tega Cay, SC 29704-7205
Phone (803) 802-4733
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D14688 | Medicaid | SC |
Other providers in Tega Cay, SC
- Noah Stalnaker
- Stateline Family Chiropractic LLC
- Andrea Carla Steele
- Kymm Stefero
- Kaitlin Rose Sugarman
- Tega Cay Family Dentistry
- Tega Cay Rescue Squad, Inc
- Tega Cay Speaks
- Tega Cay Speaks, LLC
- Beverly Tracy
All providers in Tega Cay, SC · Optometrist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.