Provider Demographics
NPI:1275037566
Name:SAWYER OPTOMETRIC SERVICES LLC
Entity Type:Organization
Organization Name:SAWYER OPTOMETRIC SERVICES LLC
Other - Org Name:COOS EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-356-3000
Mailing Address - Street 1:1319 WHITE MOUNTAIN HWY
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-5155
Mailing Address - Country:US
Mailing Address - Phone:603-356-3000
Mailing Address - Fax:603-356-4101
Practice Address - Street 1:1319 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5155
Practice Address - Country:US
Practice Address - Phone:603-356-3000
Practice Address - Fax:603-356-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty