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Contact Information

JRGOLD, INC
1120 LAKE LAND BLVD STE 1
MATTOON, IL61938-5562
 Phone: 217-258-8466
 Fax: 217-258-8443
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for JRGOLD INC · (Female)

NPI Number 1851500524
Status Active
Credentials
Entity Individual
Enumeration date 05/21/2007
Last updated 08/12/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 046007322
  • IL Medicaid 046007322
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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