Provider Demographics
NPI:1609037076
Name:I CARE OPTICAL CENTER INC
Entity Type:Organization
Organization Name:I CARE OPTICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:RODIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-825-9181
Mailing Address - Street 1:1205 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-2530
Mailing Address - Country:US
Mailing Address - Phone:856-825-9181
Mailing Address - Fax:856-825-6430
Practice Address - Street 1:1205 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2530
Practice Address - Country:US
Practice Address - Phone:856-825-9181
Practice Address - Fax:856-825-6430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0890880001Medicare NSC