Provider Demographics
NPI:1427191907
Name:FALMOUTH VISION CENTER
Entity Type:Organization
Organization Name:FALMOUTH VISION CENTER
Other - Org Name:FALMOUTH VISION CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BELLEVUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-781-2600
Mailing Address - Street 1:204 US ROUTE ONE
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105
Mailing Address - Country:US
Mailing Address - Phone:207-781-2600
Mailing Address - Fax:207-781-7299
Practice Address - Street 1:204 US ROUTE ONE
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-2600
Practice Address - Fax:207-781-7299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1427191907Medicare UPIN
ME0480760001Medicare NSC