Provider Demographics
NPI:1215024666
Name:REMKE GROUP PC
Entity Type:Organization
Organization Name:REMKE GROUP PC
Other - Org Name:REMKE EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:REMKE
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:931-762-5595
Mailing Address - Street 1:250 N MILITARY AVE
Mailing Address - Street 2:PO BOX 620
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3326
Mailing Address - Country:US
Mailing Address - Phone:931-762-5595
Mailing Address - Fax:931-766-2273
Practice Address - Street 1:250 N MILITARY AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3326
Practice Address - Country:US
Practice Address - Phone:931-762-5595
Practice Address - Fax:931-766-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3940264Medicaid
TN3940264Medicare ID - Type UnspecifiedCIGNA
TN3940264Medicaid