Provider Demographics
NPI:1104572494
Name:ERICA JURAS OD, LLC
Entity type:Organization
Organization Name:ERICA JURAS OD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:JURAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-223-3447
Mailing Address - Street 1:815 JEB STUART RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9161
Mailing Address - Country:US
Mailing Address - Phone:843-718-4131
Mailing Address - Fax:
Practice Address - Street 1:3951 W ASHLEY CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-9156
Practice Address - Country:US
Practice Address - Phone:843-718-4131
Practice Address - Fax:843-806-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty