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Organization

JFJ EYECARE LTD

Active
Other names
Quantum Vision Centers
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA LYNN CUMMINS (INSURANCE DEPT. ADMINISTRATOR)
(618) 277-1130
Entity
Organization

Contact information

Practice address
12 PROFESSIONAL PARK DR, MARYVILLE, IL 62062-5672
(636) 200-4393
(618) 288-4583
Mailing address
111 W LINCOLN ST, BELLEVILLE, IL 62220-2019
(618) 277-1130
(618) 277-4917

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
203195
MEDICARE
IL
Enumeration date
09/22/2011
Last updated
06/21/2019
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