NPI 1063401693 · live from the CMS NPI Registry
Casco Bay Eyecare LLC
Optometrist in South Portland, ME. National Provider Identifier 1063401693, active.
NPI record
| NPI | 1063401693 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 144 Thadeus St, South Portland, ME 04106 |
| Practice phone | 207-885-8686 |
| Mailing address | Po Box 7487, Portland, ME 04112 |
| Enumerated | October 17, 2005 |
| Last updated | August 20, 2020 |
| Authorized official | Rebecca Darling, Group Administrator |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.