Basic Information
| Provider Information | |||||||||
| NPI: | 1760443329 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TUOMEY OPHTHALMOLOGY SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 N WASHINGTON ST | ||||||||
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| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504949 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037785279 | ||||||||
| FaxNumber: | 8037785226 | ||||||||
| Practice Location | |||||||||
| Address1: | 365 W WESMARK BLVD | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291501987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8039058020 | ||||||||
| FaxNumber: | 8039058025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2006 | ||||||||
| LastUpdateDate: | 03/05/2008 | ||||||||
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| AuthorizedOfficialLastName: | COX | ||||||||
| AuthorizedOfficialFirstName: | RALPH | ||||||||
| AuthorizedOfficialMiddleName: | JAY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 8037788600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 19334 | SC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | GP4063 | 05 | SC | MEDICAID | DD5089 | 01 | SC | RAILROAD MEDICARE # | OTHER |