Provider Demographics
NPI:1780856245
Name:ACUITY EYECARE, LLC
Entity type:Organization
Organization Name:ACUITY EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-893-8628
Mailing Address - Street 1:223 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3186
Mailing Address - Country:US
Mailing Address - Phone:603-893-8628
Mailing Address - Fax:603-893-4076
Practice Address - Street 1:223 MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3186
Practice Address - Country:US
Practice Address - Phone:603-893-8628
Practice Address - Fax:603-893-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH620152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008308Medicaid
NHU56696Medicare UPIN
RE3749Medicare PIN