Provider Demographics
NPI:1508184748
Name:NASH ENTERPRISES
Entity Type:Organization
Organization Name:NASH ENTERPRISES
Other - Org Name:NORTH COURT OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NASH
Authorized Official - Suffix:I
Authorized Official - Credentials:LDO
Authorized Official - Phone:330-725-3937
Mailing Address - Street 1:707 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1749
Mailing Address - Country:US
Mailing Address - Phone:330-725-3937
Mailing Address - Fax:
Practice Address - Street 1:707 N COURT ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1749
Practice Address - Country:US
Practice Address - Phone:330-725-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X, 332H00000X
OHSC3483156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty