Provider Demographics
NPI:1760677090
Name:MOMANS INC
Entity Type:Organization
Organization Name:MOMANS INC
Other - Org Name:MOMANS EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:VANOY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-547-7537
Mailing Address - Street 1:221 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-3713
Mailing Address - Country:US
Mailing Address - Phone:256-547-7537
Mailing Address - Fax:256-547-7877
Practice Address - Street 1:221 BROAD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-3713
Practice Address - Country:US
Practice Address - Phone:256-547-7537
Practice Address - Fax:256-547-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS865TA419152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1837639OtherUNITED HEALTHCARE
AL529802860Medicaid
1837639OtherUNITED HEALTHCARE
ALU67024Medicare UPIN
AL529802860Medicaid