Pro-Vac, Inc

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

31TD00300700 Issued in NJ

Legal business name

PRO-VAC, INC

Practice address

2315 Bridge Ave
Point Pleasant Boro, NJ 08742-4329

Phone

(732) 892-7717

Fax

(732) 892-7836

NPI assigned

Feb 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Judith Carletta, OPTICIANNPI 1447331392

Title

Vice Presidant/Optician

Phone

(732) 892-7717

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• able opticians Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judith Carletta, OPTICIAN

  • Optician
  • Point Pleasant Boro, NJ
  • NPI 1447331392
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1043498439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424329",
            "telephone_number": "732-892-7717",
            "fax_number": "732-892-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424329",
            "telephone_number": "732-892-7717",
            "fax_number": "732-892-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-VAC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CARLETTA",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "VICE PRESIDANT/OPTICIAN",
        "authorized_official_telephone_number": "732-892-7717",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "31TD00300700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "313227",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED",
            "identifier": "110308",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "1K8390",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8577803",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "02719",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "able opticians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Customized Equipment (DME) in Point Pleasant Boro, NJ
• Providers in Point Pleasant Boro, NJ by specialty
• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.