Provider Demographics
NPI:1518146638
Name:FALL RIVER VISION CENTER
Entity Type:Organization
Organization Name:FALL RIVER VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:POSNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:508-673-2370
Mailing Address - Street 1:520 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-2366
Mailing Address - Country:US
Mailing Address - Phone:508-673-2370
Mailing Address - Fax:508-673-5834
Practice Address - Street 1:520 NEWTON ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-2366
Practice Address - Country:US
Practice Address - Phone:508-673-2370
Practice Address - Fax:508-673-5834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0191700001Medicare NSC