SOUTHCOAST OPTICAL SHOP, INC. (NPI# 1740232743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740232743 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST OPTICAL SHOP, INC. |
| Practice Address |
300a Faunce Corner Rd Suite 101 North Dartmouth MA 02747-1257 |
| Practice Telephone | 5089951963 |
| Practice Fax Number | 5089956808 |
| Mailing Telephone | 5089951963 |
| Mailing Fax Number | 5089956808 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL J HORAN (OPTICIAN) |
| Authorized Official Telephone | 5089951963 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
124350 | MA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | TUFTS # OPTICAL SHOP | 616948 | 01 |
| MA | 9732390 | 05 | |
| MA | MA/BC DME | Q04198 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SOUTHCOAST OPTICAL SHOP, INC. | 300a Faunce Corner Rd., N. Dartmouth, MA 02747 |
| Street Address |
300A FAUNCE CORNER RD SUITE 101 |
| City | NORTH DARTMOUTH |
| State | MA |
| Zip Code | 02747-1257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043792898 | Sarah Anne Crowley | Nurse Practitioner | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2018-08-29 |
| 1619425295 | Rute I Lameiro | Nurse Practitioner | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2016-09-13 |
| 1780060889 | Kristen Meiggs | Nurse Practitioner | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2015-07-31 |
| 1245619972 | Devin Lynde Bean | Physician Assistant | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2015-05-27 |
| 1487045654 | Southcoast Physicians Group, Inc. | Internal Medicine | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2015-02-10 |
| 1902201536 | Southcoast Physicians Group, Inc. | Orthopaedic Surgery | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2014-10-24 |
| 1871913061 | Yvonne Khazen | Physician Assistant | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2014-04-26 |
| 1104179613 | Laura C Lima | Nurse Practitioner | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2012-10-22 |
| 1396092698 | Qiu Ci Li | Physician Assistant | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2012-08-07 |
| 1285997734 | Mark Edmund Perry | Surgery | 300a Faunce Corner Rd, North Dartmouth, MA 02747-1280 | 2012-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619432531 | Michelle Mulvey-sylvia | Nurse Practitioner | 237 State Road, Dartmouth, MA 02747 | 2019-02-05 |
| 1679078232 | Andrew Paul Macedo | Emergency Medical Technician, Basic | 80 Alpha Street, Dartmouth, MA 02747 | 2018-03-27 |
| 1255712378 | Courtney Mota Trevino | Optometrist | 83b Faunce Corner Rd, North Dartmouth, MA 02747 | 2015-06-15 |
| 1215323852 | Kara J. Kopaczewski | Family Medicine | 49 State Rd Pequot Bldg, Ste 204, North Dartmouth, MA 02747 | 2015-04-10 |
| 1427465368 | Glicksman-gomes, LLC | Dentist | 49 State Road Nauset Bldg., Dartmouth, MA 02747 | 2014-07-11 |
| 1033544846 | Blackstone Behavioral Health Services | Psychologist | 145k Faunce Corner Rd., North Dartmouth, MA 02747 | 2013-09-11 |
| 1477999894 | Christina Nicolau | Counselor | 145k Faunce Corner Road, North Dartmouth, MA 02747 | 2013-05-13 |
| 1770823882 | Wendy Stacy | Behavioral Analyst | 145 Fauce Corner Rd., N. Dartmouth, MA 02747 | 2013-02-26 |
| 1952653131 | Eye Health Associates Inc | Optometrist | 51 State Road, Dartmouth, MA 02747 | 2012-10-11 |
| 1265782866 | Helpful Hands, Inc | Home Health | 106a State Rd, N Dartmouth, MA 02747 | 2012-09-12 |
| Find all providers in zip 02747 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073726618 | Patricia Ann Horan | Technician/Technologist | 51 State Rd, North Dartmouth, MA 02747-3319 | 2007-05-08 |
| 1316041411 | Wal-mart Stores East, Lp | Technician/Technologist | 506 State Rd, North Dartmouth, MA 02747-1802 | 2006-09-11 |
| 1043273477 | Eye Health Vision Centers,llc | Technician/Technologist | 51 State Rd, North Dartmouth, MA 02747-3319 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473560 | Irma Montanez | Technician/Technologist | 71 Lyndale St, Springfield, MA 01108-2410 | 2020-10-05 |
| 1609491331 | David Miller | Technician/Technologist | 10 Merrimack St, Lowell, MA 01852-1722 | 2020-06-09 |
| 1538718796 | Lauren Downey | Technician/Technologist | 40 Industrial Park Rd # 202, Plymouth, MA 02360-4884 | 2019-09-10 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1841769460 | Jeffrey Shwom | Technician/Technologist | 40 Holland Street, 1st Floor, Somerville, MA 02144 | 2018-11-14 |
| 1689161846 | Andrew Metz | Technician/Technologist | 188 Park Ave, Worcester, MA 01609-2240 | 2018-04-13 |
| 1144720301 | See South End Inc | Technician/Technologist | 681 Tremont St Unit 1, Boston, MA 02118-1281 | 2018-02-14 |
| 1528570702 | Michael Josef Leduc | Technician/Technologist | 73 Home St Apt 1, Fall River, MA 02720-5315 | 2017-10-28 |
| 1235649955 | Nickolas Linna | Technician/Technologist | 120 East St, Ludlow, MA 01056-3409 | 2017-10-08 |
| 1750819991 | Eye Center Optical, Inc. | Technician/Technologist | 13 Walnut Street, Winchendon, MA 01475 | 2017-06-01 |
| Find all providers with the same taxonomy | ||||
| City | NORTH DARTMOUTH |
| Zip Code | 02747 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.