Organization
FAMILY EYE HEALTH & CONTACT LENS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERIDON GOVE OD (OPTOMETRIST)
(207) 782-9501
Entity
Organization
Contact information
Practice address
220 SABATTUS ST, LEWISTON, ME 04240-6347
(207) 782-9501
(207) 782-3565
Mailing address
220 SABATTUS ST, LEWISTON, ME 04240-6347
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT602
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000023
ANTHEM ID #
ME
01
—
006524082
CIGNA ID #
ME
05
—
105560000
—
ME
01
—
410004189
MEDICARE TRAVELERS ID #
ME
01
—
M52420
CIGNA HEALTHSOURCE #
ME
Enumeration date
09/30/2006
Last updated
02/19/2020
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