Healthcare Provider Details

I. General information

NPI: 1356523468
Provider Name (Legal Business Name): ST. CROIX VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 NISKY CENTER SUITE #19 NISKY CENTER
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: 340-778-0977
Mailing address:
  • Phone: 340-773-2020
  • Fax: 340-778-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARL F MASCHAUER
Title or Position: PRESIDENT
Credential: O.D.,
Phone: 340-773-2020