MEDICARE: ROCK ISLAND OPTOMETRIC CENTER LTD

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
1	152W00000X	Optometrist		IL

General Provider Information

NPI Number	:	1275526931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK ISLAND OPTOMETRIC CENTER LTD

Provider Business Mailing Address
First Line	:	2501 24TH STREET
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-5300
Country	:	US
Telephone Number	:	309-788-0604
Fax Number	:	309-788-0611

Provider Business Practice Location Address
First Line	:	2501 24TH STREET
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61201-5300
Country	:	US
Telephone Number	:	309-788-0604
Fax Number	:	309-788-0611

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. TIMOTHY P ARBET
Credential	:	O.D.
Telephone Number	:	309-788-0604

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	07/21/2022

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Directions to “ROCK ISLAND OPTOMETRIC CENTER LTD ” Practice Location

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