Provider Demographics
NPI:1356539829
Name:GERALDINE MAYS
Entity type:Organization
Organization Name:GERALDINE MAYS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:RDO
Authorized Official - Phone:508-880-9500
Mailing Address - Street 1:625 COUNTY ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3651
Mailing Address - Country:US
Mailing Address - Phone:508-880-9500
Mailing Address - Fax:508-880-9500
Practice Address - Street 1:625 COUNTY ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3651
Practice Address - Country:US
Practice Address - Phone:508-880-9500
Practice Address - Fax:508-880-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4521332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5083100001Medicare NSC