Healthcare Provider Details

I. General information

NPI: 1972898997
Provider Name (Legal Business Name): RUMMEL EYECARE LOWVISION CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2206 W COUNTY LINE RD
JACKSON NJ
08527-2251
US

IV. Provider business mailing address

2206 WEST COUNTY LINE ROAD
JACKSON NJ
08527
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-4111
  • Fax: 732-901-0314
Mailing address:
  • Phone: 732-364-4111
  • Fax: 732-901-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00275200
License Number StateNJ

VIII. Authorized Official

Name: ERROL RUMMEL
Title or Position: OWNER
Credential: OD
Phone: 732-364-4111