Provider Demographics
NPI:1821291378
Name:JOHN P LYNCH OPTICIANS INC
Entity Type:Organization
Organization Name:JOHN P LYNCH OPTICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISPENSING OPTICIAN PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:419-893-3351
Mailing Address - Street 1:5655 MONCLOVA ROAD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1835
Mailing Address - Country:US
Mailing Address - Phone:419-893-3351
Mailing Address - Fax:419-893-3352
Practice Address - Street 1:5655 MONCLOVA ROAD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1835
Practice Address - Country:US
Practice Address - Phone:419-893-3351
Practice Address - Fax:419-893-3352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1623ASC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
155559OtherANTHEM
10252OtherPRAMOUNT
10252OtherPRAMOUNT