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Contact Information

COASTAL VISION CARE LLC
605 SAINT JAMES AVE
GOOSE CREEK, SC29445
 Phone: 843-863-1215
 Fax: 843-553-7335
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for COASTAL VISION CARE LLC

NPI Number 1689777849
LBN Legal business name COASTAL VISION CARE LLC
Authorized official DIANE JURAS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/06/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
SC License # SC0956
SC Medicaid D09569
SC Medicaid DA9726
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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