MEDICARE: CRAIG T. RUMPLE, O.D., P.A.

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	983	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700922853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAIG T. RUMPLE, O.D., P.A.

Provider Business Mailing Address
First Line	:	655 FAIRVIEW RD
Second Line	:	SUITE L
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-6777
Country	:	US
Telephone Number	:	864-963-2828
Fax Number	:	864-967-9099

Provider Business Practice Location Address
First Line	:	655 FAIRVIEW RD
Second Line	:	SUITE L
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-6777
Country	:	US
Telephone Number	:	864-963-2828
Fax Number	:	864-967-9099

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG THOMAS RUMPLE
Credential	:	O.D.
Telephone Number	:	864-963-2828

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	10/22/2011

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