Organization
CASCO BAY EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA DARLING (GROUP ADMINISTRATOR)
(207) 885-8686
Entity
Organization
Contact information
Practice address
144 THADEUS ST, SOUTH PORTLAND, ME 04106-6259
(207) 885-8686
(207) 883-7154
Mailing address
PO BOX 7487, PORTLAND, ME 04112-7487
(207) 885-8686
(207) 883-7154
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154790000
—
ME
05
—
154790001
—
ME
05
—
154790002
—
ME
05
—
154790003
—
ME
05
—
154790004
—
ME
Enumeration date
10/17/2005
Last updated
08/20/2020
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