Provider Demographics
NPI:1114361854
Name:CHARLES M. CUMMINS, OD, PA
Entity Type:Organization
Organization Name:CHARLES M. CUMMINS, OD, PA
Other - Org Name:VISIONWORKS DOCTORS OF OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:973-568-7680
Mailing Address - Street 1:PO BOX 846338
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6338
Mailing Address - Country:US
Mailing Address - Phone:210-340-3531
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:802 BAYONNE CROSSING WAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-0000
Practice Address - Country:US
Practice Address - Phone:201-858-5616
Practice Address - Fax:201-858-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier