Dr Jack Herrle OD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

000573 Issued in CT

Legal business name

DR JACK HERRLE OD

Practice address

130 East Main St
Meriden, CT 06450

Phone

(203) 237-8988

Fax

(203) 237-8980

NPI assigned

Feb 1, 2008

Last updated

Feb 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jack N Herrle, OD

Title

Owner Optometrist

Phone

(203) 237-8988

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1528246568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 EAST MAIN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-237-8988",
            "fax_number": "203-237-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 EAST MAIN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-237-8988",
            "fax_number": "203-237-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JACK HERRLE OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "HERRLE",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "203-237-8988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CT",
            "license": "000573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Meriden, CT
• Providers in Meriden, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.