Healthcare Provider Details
I. General information
NPI: 1518146638
Provider Name (Legal Business Name): FALL RIVER VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2007
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
520 NEWTON ST
FALL RIVER MA
02721-2366
US
IV. Provider business mailing address
520 NEWTON ST
FALL RIVER MA
02721-2366
US
V. Phone/Fax
- Phone: 508-673-2370
- Fax: 508-673-5834
- Phone: 508-673-2370
- Fax: 508-673-5834
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
DOUGLAS
S
POSNER
Title or Position: OWNER
Credential: O.D.
Phone: 508-673-2370