Provider Demographics
NPI:1093867731
Name:CUMMINGS OPTICAL INC.
Entity Type:Organization
Organization Name:CUMMINGS OPTICAL INC.
Other - Org Name:CUMMINGS WOODALL OPTICIANS WESTLAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:440-835-0085
Mailing Address - Street 1:27059 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4064
Mailing Address - Country:US
Mailing Address - Phone:440-835-0085
Mailing Address - Fax:440-835-0097
Practice Address - Street 1:27059 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4064
Practice Address - Country:US
Practice Address - Phone:440-835-0085
Practice Address - Fax:440-835-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18409760332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0601980001Medicare NSC