Provider Demographics
NPI:1568232940
Name:CARGUS IN THE COMMUNITY LLC
Entity Type:Organization
Organization Name:CARGUS IN THE COMMUNITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSETTA
Authorized Official - Middle Name:CARGUS
Authorized Official - Last Name:NWAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:205-477-0229
Mailing Address - Street 1:500 FLINT PARC CIR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-6157
Mailing Address - Country:US
Mailing Address - Phone:205-422-6248
Mailing Address - Fax:
Practice Address - Street 1:1201 POWDER PLANT RD UNIT 15
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5247
Practice Address - Country:US
Practice Address - Phone:205-477-0229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty