Provider Demographics
NPI:1588763189
Name:VISION CARE OF MAINE-AROOSTOOK LLC
Entity type:Organization
Organization Name:VISION CARE OF MAINE-AROOSTOOK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-989-0300
Mailing Address - Street 1:173 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3103
Mailing Address - Country:US
Mailing Address - Phone:207-764-0376
Mailing Address - Fax:207-764-7612
Practice Address - Street 1:173 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3103
Practice Address - Country:US
Practice Address - Phone:207-764-0376
Practice Address - Fax:207-764-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1588763189Medicaid
ME1588763189OtherMEDICARE
ME1588763189OtherMEDICARE