Provider Demographics
NPI:1942519681
Name:BENDER EYECARE INC.
Entity Type:Organization
Organization Name:BENDER EYECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-740-2000
Mailing Address - Street 1:9925 HAYNES BRIDGE RD
Mailing Address - Street 2:SUITE 710A
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8532
Mailing Address - Country:US
Mailing Address - Phone:770-740-2000
Mailing Address - Fax:
Practice Address - Street 1:9925 HAYNES BRIDGE RD
Practice Address - Street 2:SUITE 710A
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30022-8532
Practice Address - Country:US
Practice Address - Phone:770-740-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty