Organization
BOLDCOAST EYECARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE A HAAS (BILLER)
(877) 333-0323
Entity
Organization
Contact information
Practice address
251 US ROUTE 1, SUITE W9B, FALMOUTH, ME 04105-1322
(207) 347-3333
Mailing address
251 US ROUTE 1, SUITE W9B, FALMOUTH, ME 04105-1322
(207) 347-3333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP805
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100229
ANTHEM PROVIDER ID
ME
01
—
4619720
AETNA PROVIDER ID
ME
Enumeration date
03/19/2007
Last updated
08/22/2020
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