Provider Demographics
NPI:1922457183
Name:ZEN EYE CARE PLLC
Entity Type:Organization
Organization Name:ZEN EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHJANEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:218-522-4645
Mailing Address - Street 1:3715 GREYSOLON PL
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804-2027
Mailing Address - Country:US
Mailing Address - Phone:218-522-4645
Mailing Address - Fax:
Practice Address - Street 1:2106 LONDON ROAD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812
Practice Address - Country:US
Practice Address - Phone:218-522-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19686757Medicaid
COV06542Medicare UPIN