Healthcare Provider Details

I. General information

NPI: 1376059527
Provider Name (Legal Business Name): ST. CROIX VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 12/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 NISKY CENTER SUITE 19
ST THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 5996
CHRISTIANSTED VI
00823-5996
US

V. Phone/Fax

Practice location:
  • Phone: 340-776-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL MASCHAUER
Title or Position: PRESIDENT
Credential: OD
Phone: 302-381-2696