Provider Demographics
NPI:1174700876
Name:RENEE ABRASSART RAMSEY
Entity type:Organization
Organization Name:RENEE ABRASSART RAMSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ABRASSART
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-354-3331
Mailing Address - Street 1:PO BOX 205
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47567-0205
Mailing Address - Country:US
Mailing Address - Phone:812-354-3331
Mailing Address - Fax:812-354-3331
Practice Address - Street 1:102 S 2ND ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47567
Practice Address - Country:US
Practice Address - Phone:812-354-3331
Practice Address - Fax:812-354-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100154830AMedicaid
IN0294800001Medicare NSC
IN100154830AMedicaid