Provider Demographics
NPI:1477089845
Name:SIGHTHEALTH PRIMARY EYECARE, PA
Entity Type:Organization
Organization Name:SIGHTHEALTH PRIMARY EYECARE, PA
Other - Org Name:SIGHTHEALTH PRIMARY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JENILEE
Authorized Official - Middle Name:
Authorized Official - Last Name:REBARBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:904-217-7099
Mailing Address - Street 1:PO BOX 550961
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32255-0961
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 GATEWAY CIR UNIT 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-4085
Practice Address - Country:US
Practice Address - Phone:904-217-7099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4962152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty