Healthcare Provider Details

I. General information

NPI: 1841437167
Provider Name (Legal Business Name): BC EYE CARE P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2009
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 LOUDON RD STE #2000
CONCORD NH
03301-8005
US

IV. Provider business mailing address

30 BIRCH ST UNIT #1
DERRY NH
03038-2120
US

V. Phone/Fax

Practice location:
  • Phone: 603-247-1598
  • Fax:
Mailing address:
  • Phone: 603-225-8305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0774
License Number StateNH

VIII. Authorized Official

Name: DR. BAO CHE
Title or Position: MANAGER
Credential: O.D.
Phone: 603-247-1598