Provider Demographics
NPI:1639642358
Name:C-LUMINOUS EYECARE, INC.
Entity Type:Organization
Organization Name:C-LUMINOUS EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPOTMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIOARA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-864-6510
Mailing Address - Street 1:221 JOCELYN LN
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-9648
Mailing Address - Country:US
Mailing Address - Phone:954-864-6510
Mailing Address - Fax:
Practice Address - Street 1:1638 RIO RD E
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1405
Practice Address - Country:US
Practice Address - Phone:434-973-7996
Practice Address - Fax:434-973-7992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center