=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730390931
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RFG EYE ASSOCIATES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2007
-----------------------------------------------------
Last Update Date | 05/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 827 CENTRAL AVE SUITE NUMBER 3
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03820-2577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-749-9122
-----------------------------------------------------
Fax | 603-749-2803
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 827 CENTRAL AVE SUITE NUMBER 3
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03820-2577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-749-9122
-----------------------------------------------------
Fax | 603-749-2803
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARK PERRI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-749-9122
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------