Provider Demographics
NPI:1316900863
Name:ANDREWS VISION CENTER
Entity type:Organization
Organization Name:ANDREWS VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:POSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-650-2400
Mailing Address - Street 1:21 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:SC
Mailing Address - Zip Code:29510-2635
Mailing Address - Country:US
Mailing Address - Phone:843-264-5200
Mailing Address - Fax:
Practice Address - Street 1:21 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510-2635
Practice Address - Country:US
Practice Address - Phone:843-264-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9982Medicaid
SCDA9982Medicaid
SCU24193Medicare UPIN
SCT23842Medicare UPIN
SC0334680002Medicare NSC