Provider Demographics
NPI:1760578181
Name:CUMBERLAND FAMILY EYE CARE, LTD.
Entity Type:Organization
Organization Name:CUMBERLAND FAMILY EYE CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-726-2929
Mailing Address - Street 1:248 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-8134
Mailing Address - Country:US
Mailing Address - Phone:401-726-2929
Mailing Address - Fax:401-729-1054
Practice Address - Street 1:248 BROAD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-8134
Practice Address - Country:US
Practice Address - Phone:401-726-2929
Practice Address - Fax:401-729-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RICF00226Medicaid
RI0372270001Medicare NSC
RICF00226Medicaid