| Organization Name: | BLUE RIDGE EYE CENTER, P.A. |
| NPI Number: | 1639130305 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH C. MASSIOS (PRACTICE MANAGER) |
| Mailing Address: | 530 By Pass 123 Suite C Seneca |
| State: | SC US |
| Postal Code: | 296780844 |
| Phone Number: | 8649851110 |
| Fax Number: | 8649851410 |
| NPI Enumeration Date: | 03/31/2006 |
| NPI Last Update Date: | 05/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 5655540001 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |