Basic Information
| Provider Information | |||||||||
| NPI: | 1528257920 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTER FOR SIGHT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1565 N MAIN ST | ||||||||
| Address2: | STE. 406 | ||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027202972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086770041 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1565 N MAIN ST | ||||||||
| Address2: | STE. 406 | ||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027202972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086770041 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2007 | ||||||||
| LastUpdateDate: | 10/15/2009 | ||||||||
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| AuthorizedOfficialLastName: | OBRIEN | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5086770041 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | 207W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology | 332H00000X | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
ID Information
| ID | Type | State | Issuer | Description | 1519093 | 05 | MA | MEDICAID |