Magnolia Eye Associates Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MAGNOLIA EYE ASSOCIATES INC

Practice address

2701 David McLeod Blvd
Florence, SC 29501

Phone

(843) 664-2000

NPI assigned

Oct 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lawrence R Custer, O.D.

Title

President

Phone

(843) 424-2553

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1124595319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9547 EDGERTON DR APT 901",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295725422",
            "telephone_number": "843-424-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 DAVID MCLEOD BLVD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29501",
            "telephone_number": "843-664-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA EYE ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "CUSTER",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-424-2553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shavonte Nicole Mack, PHLEBOTOMIST, MOBILE
• Jenna Jones Maclennan, M.D.
• Douglas Alexander Macpherson, MD
• Diana Vannessa Magana, CAA
• Earnest Edward Magazine
• Magnolia Network
• Magnolia Wellness and Testing LLC
• Betty R Mahoney, RPH
• Shante' Denise Major, M.S., CCC-SLP
• Michael Brandon Maksin, PA

• Optometrist in Florence, SC
• Providers in Florence, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.