Provider Demographics
NPI:1174286355
Name:NJP EYECARE, LLC
Entity Type:Organization
Organization Name:NJP EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:541-567-3790
Mailing Address - Street 1:298 E GLADYS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-1803
Mailing Address - Country:US
Mailing Address - Phone:541-567-3790
Mailing Address - Fax:541-567-3791
Practice Address - Street 1:298 E GLADYS AVE STE B
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838-1803
Practice Address - Country:US
Practice Address - Phone:541-567-3790
Practice Address - Fax:541-567-3791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier