Eyemart Express LLC

NPI #1699125773 in Sumter, South Carolina

Provider Information

NPI Number: 1699125773
Entity Type: Organization
Organization Name: Eyemart Express LLC
Subpart: Yes (part of a larger organization)
Parent Organization: EYEMART EXPRESS LLC
Primary Specialty: Eyewear Supplier
Enumeration Date: Jun 20, 2016
Last Updated: Jun 20, 2016

Practice Location

Address: 1177 BROAD ST
Address 2: SUITE B
City: Sumter
State: South Carolina
ZIP Code: 29150-1932
Phone: (803) 720-5765

Authorized Official

Name: KIM CARUSO
Title: DIRECTOR OF CREDENTIALING
Phone: (212) 792-8136

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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