Provider Demographics
NPI:1295929354
Name:BENDER OPTICAL INC
Entity type:Organization
Organization Name:BENDER OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BENDER
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:513-871-2127
Mailing Address - Street 1:3870 PAXTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2366
Mailing Address - Country:US
Mailing Address - Phone:513-871-2127
Mailing Address - Fax:513-871-2128
Practice Address - Street 1:3870 PAXTON AVE STE B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2366
Practice Address - Country:US
Practice Address - Phone:513-871-2127
Practice Address - Fax:513-871-2128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSC1376332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0484650001Medicare NSC