Pack, Alva S

Pack, Alva S is an individual health care provider with primary practice located at 399 E Henry St , Spartanburg SC 29302-2639. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Pack, Alva S can be contacted via phone (864) 585-0208.

Contact Information

Primary practice address
399 E Henry St Spartanburg SC 29302-2639
Fax: (864) 594-6783
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 489 South Carolina

Profile Details

NPI number 1407811573
LBN Legal business name Pack, Alva S
Credentials O.D. P.A.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407811573 NPPES
South Carolina MEDICAID D04895

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