1043327687 NPI number — EYE HEALTH VISION CENTERS OF RHODE ISLAND INC

Table of content: (NPI 1043327687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043327687 NPI number — EYE HEALTH VISION CENTERS OF RHODE ISLAND INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE HEALTH VISION CENTERS OF RHODE ISLAND INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EYE HEALTH VISION CENTERS,LLC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043327687
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
51 STATE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH DARTMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02747-3319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-994-1400
Provider Business Mailing Address Fax Number:
508-910-2212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
73 VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02842-5234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-841-0966
Provider Business Practice Location Address Fax Number:
404-841-0966
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SULLIVAN
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
F
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-994-1400

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2490001 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com