Provider Demographics
NPI:1952579526
Name:FRANK PIERSON OPTICIAN LLC
Entity Type:Organization
Organization Name:FRANK PIERSON OPTICIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:207-667-8879
Mailing Address - Street 1:83 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1902
Mailing Address - Country:US
Mailing Address - Phone:207-667-8879
Mailing Address - Fax:
Practice Address - Street 1:83 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1902
Practice Address - Country:US
Practice Address - Phone:207-667-8879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME0129560001Medicare NSC