Provider Demographics
NPI:1366757593
Name:SUNRISE EYE CARE PA
Entity type:Organization
Organization Name:SUNRISE EYE CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:207-454-2277
Mailing Address - Street 1:4 PARK ST
Mailing Address - Street 2:PO BOX 405
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1609
Mailing Address - Country:US
Mailing Address - Phone:207-454-2277
Mailing Address - Fax:207-454-2910
Practice Address - Street 1:4 PARK ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1609
Practice Address - Country:US
Practice Address - Phone:207-454-2277
Practice Address - Fax:207-454-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME567T152W00000X
ME667T152W00000X
ME900T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME126350000Medicaid
MEMM4149Medicare UPIN