Provider Demographics
NPI:1902933294
Name:PROCARE VISION CENTER
Entity type:Organization
Organization Name:PROCARE VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUMP
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:440-891-1940
Mailing Address - Street 1:343 W BAGLEY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1370
Mailing Address - Country:US
Mailing Address - Phone:440-891-1940
Mailing Address - Fax:440-891-9028
Practice Address - Street 1:343 W BAGLEY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-1370
Practice Address - Country:US
Practice Address - Phone:440-891-1940
Practice Address - Fax:440-891-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH403SC332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier