Coastal Eye Care LLC
Organization Active NPI Optometrist · St Simons Island, GA
NPI 1609893650 · NPPES record last updated Apr 20, 2011
Key facts
- NPI
- 1609893650
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- COASTAL EYE CARE LLC
- Practice address
- 312 Redfern VLG
St Simons Island, GA 31522-2522 - Phone
- (912) 638-8652
- Fax
- (912) 638-0490
- NPI assigned
- Jul 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Molly Hicks Hardin
- Title
- Office Manager
- Phone
- (912) 638-8652
Practitioners 1
-
Scott A. Trefts, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041209000535 | GA | Part B Supplier - Clinic/Group Practice | 9234195363 |
Receives reassigned benefits from 1 practitioner Practice locations: St Simons Island, GA |
National Provider Directory
Locations
40 Professional Dr
Brunswick, GA 31520
Phone (912) 223-7521
2483 Demere Rd
Ste 101
St Simons Island, GA 31522
Phone (912) 638-8652
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
312 Redfern VLG
St Simons Island, GA 31522-2522
Mailing address
312 Redfern VLG
St Simons Island, GA 31522-2522
Phone (912) 638-8652
Other names
- Coastal Eye Care
Other providers in St Simons Island, GA
- Emily K Claros
- Brandon R Clements
- Coastal Community Health Services, Inc.
- Coastal Community Retirement Corporation
- Coastal Community Retirement Corporation
- Coastal Kids Dentistry
- Coastal Oral Surgery Associates
- Crane Physical Therapy and Wellness
- Mary Beth Currey
- Elizabeth Thompson Daniel
All providers in St Simons Island, GA · Optometrist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.