Healthcare Provider Details

I. General information

NPI: 1619665437
Provider Name (Legal Business Name): ATCHUE OPTICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1464 GRAFTON ROAD
MILBURY MA
01527
US

IV. Provider business mailing address

1464 GRAFTON ROAD
MILBURY MA
01527
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-5253
  • Fax: 508-754-4659
Mailing address:
  • Phone: 508-755-5253
  • Fax: 508-754-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES J ATCHUE
Title or Position: MEMBER
Credential: RDO
Phone: 508-755-5253