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General NPI Number Information
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NPI Number | 1568613784
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Entity Type | Organization
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Legal Business Name | JENNINGS EYECARE INC.
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 1180 FALL RIVER AVE NEXT TO WAL-MART VISION CENTER
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City | SEEKONK
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State | MA
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Zip | 02771-5906
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Country | US
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Telephone | 508-680-6732
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Fax | 508-916-4327
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Provider Business Mailing Address
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Address Line | 19 CARONIA ST
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City | CRANSTON
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State | RI
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Zip | 02920-4333
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Country | US
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Telephone | 401-450-5263
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Fax | 508-916-4327
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Authorized Official
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Title or Position | PRESIDENT, JENNINGS EYECARE INC.
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Name | DR. DAVID JENNINGS
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Credential | O.D.
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Telephone | 401-450-5263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4390
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License Number State | MA
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