Healthcare Provider Details

I. General information

NPI: 1184911026
Provider Name (Legal Business Name): EYE HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 WHITES PATH
SOUTH YARMOUTH MA
02664-1221
US

IV. Provider business mailing address

1900 CROWN COLONY DR SUITE 301
QUINCY MA
02169-0975
US

V. Phone/Fax

Practice location:
  • Phone: 508-398-6131
  • Fax: 508-398-7440
Mailing address:
  • Phone: 617-770-4400
  • Fax: 617-471-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC H JOHNSON
Title or Position: PRESIDENT/EYE HEALTH SERVICES
Credential: MD
Phone: 617-472-5242