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NPI Code Detail

MEDICARE: CHARLES M CUMMINS OD PA

MEDICARE: CHARLES M CUMMINS OD PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467419754
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES M CUMMINS OD PA
Provider Business Mailing Address
First Line : PO BOX 846338
Second Line :
City : DALLAS
State : TX
Zip : 75284-6338
Country : US
Telephone Number : 210-524-6663
Fax Number :
Provider Business Practice Location Address
First Line : 251 CLIFTON AVE
Second Line :
City : CLIFTON
State : NJ
Zip : 07011-1961
Country : US
Telephone Number : 973-340-2300
Fax Number : 973-340-2306
Authorized Official
Title or Position : OWNER
Name : CHARLES M. CUMMINS
Credential : O.D.
Telephone Number : 973-338-1064
Provider Enumeration Date : 04/28/2006
Last Update Date : 08/09/2013

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