Provider Demographics
NPI:1821277971
Name:CS BERRIE INC.
Entity Type:Organization
Organization Name:CS BERRIE INC.
Other - Org Name:BERRIES GUILD OPTICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:NAEGELY
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIANS
Authorized Official - Phone:207-725-5111
Mailing Address - Street 1:86 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2015
Mailing Address - Country:US
Mailing Address - Phone:207-725-5111
Mailing Address - Fax:
Practice Address - Street 1:86 MAINE ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2015
Practice Address - Country:US
Practice Address - Phone:207-725-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0724430001Medicare NSC