Provider Demographics
NPI:1346381563
Name:AUBURN VISION CENTER INC
Entity Type:Organization
Organization Name:AUBURN VISION CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-832-8820
Mailing Address - Street 1:3 CALVINS LN
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MA
Mailing Address - Zip Code:01564-2213
Mailing Address - Country:US
Mailing Address - Phone:978-563-1600
Mailing Address - Fax:603-954-8386
Practice Address - Street 1:59 AUBURN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2428
Practice Address - Country:US
Practice Address - Phone:508-832-8820
Practice Address - Fax:508-721-5145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA3972152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW201695OtherCIGNA
MAW20330OtherBLUE CROSS MASS
MA5393688OtherAETNA
MA152161OtherHARVARD PILGRIM
MA22-02752OtherUNITED HEALTH CARE
MA9734490Medicaid
MA973954OtherNETWORK HEALTH
MAU62832Medicare UPIN
MA22-02752OtherUNITED HEALTH CARE