Provider Demographics
NPI:1538197561
Name:FOCUS EYE CARE CENTER, PC
Entity type:Organization
Organization Name:FOCUS EYE CARE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-798-8642
Mailing Address - Street 1:119 LATONEA DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7572
Mailing Address - Country:US
Mailing Address - Phone:803-798-8642
Mailing Address - Fax:803-798-0422
Practice Address - Street 1:4110 MOSEBY ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207-6118
Practice Address - Country:US
Practice Address - Phone:803-790-1849
Practice Address - Fax:803-790-1846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9661Medicaid
SC5531Medicare PIN