# MAINE EYE CENTER, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720044878
- **Authorized official:** JUDITH MCCANN (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (848) 219-2109

## Contact information

- **Practice address:** 15 LOWELL ST, PORTLAND, ME 04102-2776
- **Practice address phone:** (207) 774-8277
- **Practice address fax:** (207) 523-5310
- **Mailing address:** 15 LOWELL ST, PORTLAND, ME 04102-2776
- **Mailing address phone:** (207) 774-8277
- **Mailing address fax:** (207) 523-5310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 152WC0802X | Corneal and Contact Management Optometrist | — | NULL | — |
| 152WC0802X | Corneal and Contact Management Optometrist | — | — | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | NULL | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | — | — |
| 156FX1101X | Ophthalmic Assistant | — | NULL | — |
| 156FX1101X | Ophthalmic Assistant | — | — | — |
| 156FX1202X | Optometric Technician | — | NULL | — |
| 156FX1202X | Optometric Technician | — | — | — |
| 156FX1800X | Optician | — | NULL | — |
| 156FX1800X | Optician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 10/12/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000335 | ANTHEM FACILITY GROUP \# | ME |
| 05 | — | 106700000 | — | ME |
| 05 | — | 106700100 | — | ME |
| 05 | — | 106700200 | — | ME |
| 05 | — | 106700300 | — | ME |
| 01 | — | 2359120 | AETNA FACILITY GROUP \# | ME |
| 01 | — | 490000770 | RAILROAD FACILITY GROUP \# | ME |
| 01 | — | 9720 | NH CIGNA HEALTHSOURCE GRO | NH |
| 05 | — | 99904863 | — | NH |
| 01 | — | E00118 | CHAMPUS GROUP \# | ME |
| 01 | — | M187212 | CIGNA HS FACILITY GROUP | ME |
| 01 | — | M304 | CIGNA HEALTHSOURCE GROUP | ME |