Healthcare Provider Details

I. General information

NPI: 1831108877
Provider Name (Legal Business Name): THE EYE CENTER GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N MERIDIAN ST
PORTLAND IN
47371-1024
US

IV. Provider business mailing address

1111 N MERIDIAN ST
PORTLAND IN
47371-1024
US

V. Phone/Fax

Practice location:
  • Phone: 260-726-4210
  • Fax: 260-726-9347
Mailing address:
  • Phone: 260-726-4210
  • Fax: 260-726-9347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY S RAPKIN
Title or Position: PART OWNER
Credential: MD
Phone: 765-286-8888