Organization
POULIN & ASSOCIATES EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP R POULIN OD (OWNER)
(207) 873-3500
Entity
Organization
Contact information
Practice address
166 SILVER ST, WATERVILLE, ME 04901-5815
(207) 873-3500
(207) 873-6167
Mailing address
166 SILVER ST, WATERVILLE, ME 04901-5815
(207) 873-3500
(208) 787-3616
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT712
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403780000
—
ME
01
—
DB6080
RAILROAD MEDICARE
ME
01
—
M23104
CIGNA
ME
01
—
MNT901
HARVARD PILGRIM
—
Enumeration date
09/12/2006
Last updated
11/12/2008
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