Provider Demographics
NPI:1316060007
Name:HILLCREST EYECARE, PA
Entity type:Organization
Organization Name:HILLCREST EYECARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VITAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-963-4933
Mailing Address - Street 1:309 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2653
Mailing Address - Country:US
Mailing Address - Phone:864-963-4933
Mailing Address - Fax:864-967-7020
Practice Address - Street 1:309 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2653
Practice Address - Country:US
Practice Address - Phone:864-963-4933
Practice Address - Fax:864-967-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty