Eyecare Medical Group Optical Shop

NPI #1184729915 in Portland, Maine

Provider Information

NPI Number: 1184729915
Entity Type: Organization
Organization Name: Eyecare Medical Group Optical Shop
Primary Specialty: Eyewear Supplier
Enumeration Date: Sep 14, 2006
Last Updated: Jul 31, 2023

Practice Location

Address: 53 SEWALL STREET
City: Portland
State: Maine
ZIP Code: 04102
Phone: (207) 828-2020

Authorized Official

Name: LYNN SHORTY, RN, CMPE
Title: CHIEF OPERATING OFFIER
Phone: (207) 791-8234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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