Provider Demographics
NPI:1639208655
Name:BRAD & MARY, INC.
Entity Type:Organization
Organization Name:BRAD & MARY, INC.
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-947-6591
Mailing Address - Street 1:663 STILLWATER AVE
Mailing Address - Street 2:BANGOR MALL UNIT 48
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3642
Mailing Address - Country:US
Mailing Address - Phone:207-947-6591
Mailing Address - Fax:
Practice Address - Street 1:663 STILLWATER AVE
Practice Address - Street 2:BANGOR MALL UNIT 48
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3642
Practice Address - Country:US
Practice Address - Phone:207-947-6591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0262658332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies