Provider Demographics
NPI:1447130505
Name:PANGBORN PREMIER EYE CARE, INC.
Entity type:Organization
Organization Name:PANGBORN PREMIER EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PANGBORN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:401-742-6400
Mailing Address - Street 1:133 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3511
Mailing Address - Country:US
Mailing Address - Phone:401-782-8150
Mailing Address - Fax:401-783-9710
Practice Address - Street 1:133 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3511
Practice Address - Country:US
Practice Address - Phone:401-782-8150
Practice Address - Fax:401-783-9710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty