MEDICARE: BASS RIVER OPTICAL, INC.

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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1922155258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASS RIVER OPTICAL, INC.

Provider Business Mailing Address
First Line	:	173 CRANBERRY HIGHWAY
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3206
Country	:	US
Telephone Number	:	508-240-0898
Fax Number	:	508-240-7122

Provider Business Practice Location Address
First Line	:	173 CRANBERRY HIGHWAY
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3206
Country	:	US
Telephone Number	:	508-240-0898
Fax Number	:	508-240-7122

Authorized Official
Title or Position	:	OWNER
Name	:	MS. PAIGE BAUER BARRETT
Credential	:
Telephone Number	:	508-240-0898

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	04/13/2023

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Directions to “BASS RIVER OPTICAL, INC. ” Practice Location

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