Organization
MAINE EYE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH MCCANN (DIRECTOR OF REVENUE CYCLE)
(848) 219-2109
Entity
Organization
Contact information
Practice address
15 LOWELL ST, PORTLAND, ME 04102-2776
(207) 774-8277
(207) 523-5310
Mailing address
15 LOWELL ST, PORTLAND, ME 04102-2776
(207) 774-8277
(207) 523-5310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
156FC0800X
Contact Lens Technician/Technologist
—
—
156FX1101X
Ophthalmic Assistant
—
—
156FX1202X
Optometric Technician
—
—
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
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
Enumeration date
04/25/2006
Last updated
10/12/2023
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