Provider Demographics
NPI:1073621090
Name:PETER F MORSE INC
Entity Type:Organization
Organization Name:PETER F MORSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:F
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-774-8008
Mailing Address - Street 1:213 MAINE MALL
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3229
Mailing Address - Country:US
Mailing Address - Phone:207-774-8008
Mailing Address - Fax:207-774-0990
Practice Address - Street 1:213 MAINE MALL
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3229
Practice Address - Country:US
Practice Address - Phone:207-774-8008
Practice Address - Fax:207-774-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME200460000Medicaid
MEDG9603Medicare PIN
MEME2125Medicare PIN