Provider Demographics
NPI:1841242955
Name:SOUTHCOAST EYE CARE, INC
Entity Type:Organization
Organization Name:SOUTHCOAST EYE CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PEPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-995-8200
Mailing Address - Street 1:300A FAUNCE CORNER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1257
Mailing Address - Country:US
Mailing Address - Phone:508-995-8200
Mailing Address - Fax:508-995-4631
Practice Address - Street 1:300A FAUNCE CORNER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1257
Practice Address - Country:US
Practice Address - Phone:508-995-8200
Practice Address - Fax:508-995-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI25360OtherRI BCBS GROUP #
MAC17344OtherRR MEDICARE GROUP #
MA670265OtherTUFTS GROUP #
RI1955OtherBCHIP GROUP #
MA2181804OtherAETNA GROUP #
MAW20367OtherOPTOMETRIST GROUP #
MAM17235OtherOPHTHALMOLOGIST BS #
MA17266OtherNHP GROUP #
MA9786007Medicaid
MAC17344OtherRR MEDICARE GROUP #