Jackson Davenport Inc.

LBN: Jackson Davenport Inc.
Jackson Davenport Inc. is an health care organization with primary practice located at 379 King St , Charleston SC 29401-1438. The organization recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Contact Lens Fitter, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optometrist is the primary health care specialty. Jackson Davenport Inc. can be contacted via phone (843) 722-4416, or through Davenport, Nancy Watkins via phone (843) 722-4416.

Contact Information

Primary practice address
379 King St Charleston SC 29401-1438
Phone: (843) 722-4416
Fax: (843) 720-8984
Website:
Map and Directions
Authorized official contact:
Name: Davenport, Nancy Watkins
Phone: (843) 722-4416

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 509 South Carolina
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 509 South Carolina
Eye and Vision Services Providers / Contact Lens Fitter 156FC0801X 152 South Carolina
Eye and Vision Services Providers / Optician 156FX1800X 501 South Carolina

Profile Details

NPI number 1073688602
LBN Legal business name Jackson Davenport Inc.
DBA Doing business as
Authorized official Davenport, Nancy Watkins
Entity Organization
Organization subpart 1 No
Enumeration date Nov 21st, 2006
Last updated Jul 16th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073688602 NPPES
South Carolina Other 62167 FIRST CHOICE
South Carolina MEDICAID DA9859 FIRST CHOICE

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