Provider Demographics
NPI:1487918132
Name:JAMES RIVER EYE ASSOCIATES
Entity type:Organization
Organization Name:JAMES RIVER EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:RAINER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-837-3790
Mailing Address - Street 1:5617 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2614
Mailing Address - Country:US
Mailing Address - Phone:508-837-3790
Mailing Address - Fax:804-285-3781
Practice Address - Street 1:5617 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2614
Practice Address - Country:US
Practice Address - Phone:804-282-7228
Practice Address - Fax:804-285-3781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000110152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA410000648Medicare PIN
VAT98020Medicare UPIN