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General NPI Number Information
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NPI Number | 1265995674
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Entity Type | Organization
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Legal Business Name | VISION CARE OF MAINE AROOSTOOK, LLC
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 9 KATAHDIN LN
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City | HOULTON
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State | ME
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Zip | 04730-3573
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Country | US
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Telephone | 207-532-2974
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Fax |
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Provider Business Mailing Address
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Address Line | 173 ACADEMY ST
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-3103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CRISTY HEWITT
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Credential | RN
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Telephone | 207-385-2036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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