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Organization
RIVERSIDE EYE CENTER PA
Active
Organization
RIVERSIDE EYE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE FOURNIER CMPE (PRACTICE ADMINISTRATOR)
(207) 786-1917
Entity
Organization
Contact information
Practice address
475 LISBON ST, LEWISTON, ME 04240-7418
(207) 786-2500
(207) 786-2503
Mailing address
193 MAIN ST, RIVERSIDE EYE CENTER, NORWAY, ME 04268-5645
(207) 743-0027
(207) 743-0051
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
015596
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061139
ANTHEM
—
05
—
325120099
—
ME
05
—
431545400
—
ME
01
—
M2307901
CIGNA
—
01
—
MM8909
MEDICARE
—
01
—
NX3033
MEDICARE PTAN
—
01
—
P00184354
RAILROAD MEDICARE
—
Enumeration date
09/14/2007
Last updated
08/09/2023
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