Provider Demographics
NPI:1790281467
Name:MAGIC ACE LLC
Entity Type:Organization
Organization Name:MAGIC ACE LLC
Other - Org Name:MAGIC ACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAJED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALRAYYASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-334-2488
Mailing Address - Street 1:PO BOX 1822
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48121-1822
Mailing Address - Country:US
Mailing Address - Phone:313-334-2488
Mailing Address - Fax:
Practice Address - Street 1:7560 E MORROW CIR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1644
Practice Address - Country:US
Practice Address - Phone:313-334-2488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier