Provider Demographics
NPI:1043244767
Name:MARK OHRINER OD LTD
Entity Type:Organization
Organization Name:MARK OHRINER OD LTD
Other - Org Name:MARK OHRINER OD LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-364-1252
Mailing Address - Street 1:4675 W FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3701
Mailing Address - Country:US
Mailing Address - Phone:702-364-1252
Mailing Address - Fax:702-364-9716
Practice Address - Street 1:4675 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3701
Practice Address - Country:US
Practice Address - Phone:702-364-1252
Practice Address - Fax:702-364-9716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0249152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100510101Medicaid
NVDW187AMedicare PIN
NV1001880002Medicare NSC