Provider Demographics
NPI:1083028468
Name:GREEN MOUNTAIN EYE CARE PC
Entity Type:Organization
Organization Name:GREEN MOUNTAIN EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PINARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:802-334-2772
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:530 WASHINGTON HIGHWAY
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-0698
Mailing Address - Country:US
Mailing Address - Phone:802-888-3089
Mailing Address - Fax:802-888-5391
Practice Address - Street 1:530 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8715
Practice Address - Country:US
Practice Address - Phone:802-888-3089
Practice Address - Fax:802-888-5391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0300000237152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty