Provider Demographics
NPI:1184953937
Name:ENVISION EYE CARE, PLLC
Entity type:Organization
Organization Name:ENVISION EYE CARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMEBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-444-2592
Mailing Address - Street 1:104 MEADOW ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4026
Mailing Address - Country:US
Mailing Address - Phone:603-444-2592
Mailing Address - Fax:603-444-0804
Practice Address - Street 1:104 MEADOW ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4026
Practice Address - Country:US
Practice Address - Phone:603-444-2592
Practice Address - Fax:603-444-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0014925OtherMEDICARE
NH0014925OtherMEDICARE