Provider Demographics
NPI:1336444744
Name:ELAHI EYE CARE, INC.
Entity Type:Organization
Organization Name:ELAHI EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELAHI-NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:318-680-1916
Mailing Address - Street 1:303 MCMILLAN ROAD, SUITE A
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8163
Mailing Address - Country:US
Mailing Address - Phone:318-387-7257
Mailing Address - Fax:318-325-7034
Practice Address - Street 1:303 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8316
Practice Address - Country:US
Practice Address - Phone:318-387-7257
Practice Address - Fax:318-325-7034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2434888Medicaid
LA2434888Medicaid