Healthcare Provider Details
I. General information
NPI: 1164776365
Provider Name (Legal Business Name): EYE HEALTH ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2012
Last Update Date: 03/05/2020
Certification Date: 03/05/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
933 PLEASANT ST
FALL RIVER MA
02723-1000
US
IV. Provider business mailing address
51 STATE RD
DARTMOUTH MA
02747-3319
US
V. Phone/Fax
- Phone: 508-673-2020
- Fax:
- Phone: 774-320-3040
- Fax: 508-910-2204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COREY
B
WESTERFELD
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 508-994-1400