Provider Demographics
NPI:1619145109
Name:SCOTT E. SAUNDERS
Entity Type:Organization
Organization Name:SCOTT E. SAUNDERS
Other - Org Name:NORTHWEST VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-379-7514
Mailing Address - Street 1:140 WILLOW ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06098-2092
Mailing Address - Country:US
Mailing Address - Phone:860-379-7514
Mailing Address - Fax:860-379-8505
Practice Address - Street 1:140 WILLOW ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WINSTED
Practice Address - State:CT
Practice Address - Zip Code:06098-2092
Practice Address - Country:US
Practice Address - Phone:860-379-7514
Practice Address - Fax:860-379-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT001055332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004069795Medicaid
CT004069795Medicaid
CT0182370001Medicare NSC