Provider Demographics
NPI:1447427216
Name:GEORGE F. LEE
Entity type:Organization
Organization Name:GEORGE F. LEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:843-884-7321
Mailing Address - Street 1:401 W COLEMAN BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3592
Mailing Address - Country:US
Mailing Address - Phone:843-884-7332
Mailing Address - Fax:
Practice Address - Street 1:401 W COLEMAN BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3592
Practice Address - Country:US
Practice Address - Phone:843-884-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDV2621Medicaid
SC0172770001Medicare NSC