# RIVERSIDE EYE CENTER PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Eye Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396427407
- **Authorized official:** JANICE FOURNIER CMPE (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (207) 786-1917

## Contact information

- **Practice address:** 475 LISBON ST, LEWISTON, ME 04240-7418
- **Practice address phone:** (207) 786-2500
- **Practice address fax:** (207) 786-2503
- **Mailing address:** 475 LISBON ST, LEWISTON, ME 04240-7418
- **Mailing address phone:** (207) 786-2500
- **Mailing address fax:** (207) 786-2503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/07/2023
- **Last updated:** 08/09/2023