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NPI Code Detail

MEDICARE: THE MEDICAL EYE CENTER, P.C.

MEDICARE: THE MEDICAL EYE CENTER, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1720230378
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MEDICAL EYE CENTER, P.C.
Provider Business Mailing Address
First Line : 250 RIVER RD
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-2423
Country : US
Telephone Number : 603-668-2020
Fax Number : 603-668-0881
Provider Business Practice Location Address
First Line : 250 RIVER RD
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-2423
Country : US
Telephone Number : 603-668-2020
Fax Number : 603-668-0881
Authorized Official
Title or Position : PRESIDENT
Name : GEORGE JAMES SHAKER
Credential : MD
Telephone Number : 603-668-2020
Provider Enumeration Date : 10/15/2008
Last Update Date : 11/24/2015

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Directions to “THE MEDICAL EYE CENTER, P.C. ” Practice Location

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