Provider Demographics
NPI:1942422555
Name:JOHN CAPINO,MDPC
Entity Type:Organization
Organization Name:JOHN CAPINO,MDPC
Other - Org Name:MERRIMACK EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-452-2100
Mailing Address - Street 1:1230 BRIDGE ST.
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850
Mailing Address - Country:US
Mailing Address - Phone:978-452-2100
Mailing Address - Fax:978-446-0490
Practice Address - Street 1:1230 BRIDGE ST.
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850
Practice Address - Country:US
Practice Address - Phone:978-452-2100
Practice Address - Fax:978-446-0490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA057517332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5146060001Medicare NSC