Provider Demographics
NPI:1124037163
Name:THE EYE CENTER GROUP LLC
Entity Type:Organization
Organization Name:THE EYE CENTER GROUP LLC
Other - Org Name:WINCHESTER EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-286-8888
Mailing Address - Street 1:882 E GREENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:47394-8441
Mailing Address - Country:US
Mailing Address - Phone:765-584-1320
Mailing Address - Fax:765-584-2317
Practice Address - Street 1:882 E GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:IN
Practice Address - Zip Code:47394-8441
Practice Address - Country:US
Practice Address - Phone:765-584-1320
Practice Address - Fax:765-584-2317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1179560003Medicare NSC