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BAYSTATE EYE CARE OPTICAL SHOPPE NPI 1386621068


NPI Information

NPI: 1386621068
Provider Name: BAYSTATE EYE CARE OPTICAL SHOPPE
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
275 BICENTENNIAL HWY STE 101
SPRINGFIELD, MA
ZIP 01118
Phone: (413) 783-3100
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BAYSTATE EYE CARE OPTICAL SHOPPE is an eyewear supplier in Springfield, MA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. BAYSTATE EYE CARE OPTICAL SHOPPE NPI is 1386621068. The provider is registered as an organization entity type.

The provider's business location address is:

275 BICENTENNIAL HWY STE 101
SPRINGFIELD, MA
ZIP 01118-965
Phone: (413) 783-3100
Fax: (413) 782-7998

The provider's authorized official is Steven T Berger .
The authorized official title is Owner and has the following contact phone number (413) 783-3100.

The enumeration date for this NPI number is 12/23/2005 and was last updated on 10/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear Supplier2068MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19786945MEDICAIDMASSACHUSETTS
2Q00566OTHERMASSACHUSETTSBLUE SHIELD/MEDEX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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