Provider Demographics
NPI:1497706832
Name:MACALPINE EYE CARE, P C
Entity Type:Organization
Organization Name:MACALPINE EYE CARE, P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACALPINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:781-331-4004
Mailing Address - Street 1:1690 MAIN ST
Mailing Address - Street 2:UNIT 5
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1279
Mailing Address - Country:US
Mailing Address - Phone:781-331-4004
Mailing Address - Fax:781-331-5004
Practice Address - Street 1:1690 MAIN ST
Practice Address - Street 2:UNIT 5
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1279
Practice Address - Country:US
Practice Address - Phone:781-331-4004
Practice Address - Fax:781-331-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0317748Medicaid
MA0317748Medicaid
MAW17431Medicare ID - Type Unspecified
MA0004612Medicare PIN