Provider Demographics
NPI:1023104825
Name:VISION CARE OF MAINE-AROOSTOOK LLC
Entity type:Organization
Organization Name:VISION CARE OF MAINE-AROOSTOOK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-385-2036
Mailing Address - Street 1:173 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3103
Mailing Address - Country:US
Mailing Address - Phone:207-764-0376
Mailing Address - Fax:207-764-7612
Practice Address - Street 1:173 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3103
Practice Address - Country:US
Practice Address - Phone:207-764-0376
Practice Address - Fax:207-764-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36480261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME201005Medicare ID - Type UnspecifiedMEDICARE ID NUMBER