Cummings, Randall Perry
Cummings, Randall Perry is an sole proprietor health care provider with primary practice located at 1420 S Blaine St Ste 6 , Moscow ID 83843-3973. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Cummings, Randall Perry can be contacted via phone (208) 882-2020.Contact Information
Primary practice address
1420 S Blaine St Ste 6
Moscow ID 83843-3973
Phone: (208) 882-2020
Fax: (208) 882-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | ODP - 100097 | Idaho |
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100097 | Idaho |
Profile Details
| NPI number | 1215912472 |
|---|---|
| LBN Legal business name | Cummings, Randall Perry |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Oct 14th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215912472 | NPPES |
| Idaho | MEDICAID | 807626700 |
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