Diane Grossheim, ABOC,NCLE,LDO
Technician/Technologist, Optician in Camden, SC. Individual provider (NPI-1).
NPI number1023748985
StatusActive
Last updated in NPPESJun 14, 2022
Details
- NPI
- 1023748985
- Entity type
- Individual (NPI-1)
- Name
- Diane Grossheim
- Credential
- ABOC,NCLE,LDO
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 14, 2022
- Certification date
- Jun 14, 2022
- Last updated
- Jun 14, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 1030 | SC | Yes |
Practice location
2240 W Dekalb StCamden, SC 29020-2069
Phone 803-425-9896 · Fax 803-425-8169
Mailing address
2240 W Dekalb StCamden, SC 29020-2069
Phone 803-425-9896 · Fax 803-425-8169
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