Provider Demographics
NPI:1265878946
Name:MAHAN EYE CARE INC.
Entity type:Organization
Organization Name:MAHAN EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLOS
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:BEGENY-MAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-884-3090
Mailing Address - Street 1:7969 W RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5516
Mailing Address - Country:US
Mailing Address - Phone:440-884-3090
Mailing Address - Fax:
Practice Address - Street 1:7969 W RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5516
Practice Address - Country:US
Practice Address - Phone:440-884-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4002152W00000X
OH3839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty