Basic Information
| Provider Information | |||||||||
| NPI: | 1568967131 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL MAINE EYE SURGERY CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 COMMERCE ST STE 600 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372192518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153456900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 249 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEWISTON | ||||||||
| State: | ME | ||||||||
| PostalCode: | 042407053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077839653 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2018 | ||||||||
| LastUpdateDate: | 03/27/2018 | ||||||||
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| AuthorizedOfficialLastName: | POLLEY | ||||||||
| AuthorizedOfficialFirstName: | DALE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6153456900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.