Provider Demographics
NPI:1558644930
Name:JFJ EYECARE LTD
Entity Type:Organization
Organization Name:JFJ EYECARE LTD
Other - Org Name:QUANTUM VISION CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE DEPT. ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-277-1130
Mailing Address - Street 1:111 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-2019
Mailing Address - Country:US
Mailing Address - Phone:618-277-1130
Mailing Address - Fax:618-277-4917
Practice Address - Street 1:12 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-5672
Practice Address - Country:US
Practice Address - Phone:636-200-4393
Practice Address - Fax:618-288-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203195OtherMEDICARE
IL203195OtherMEDICARE