Provider Demographics
NPI:1740275163
Name:MANN & MANN OPTOMETRISTS PC
Entity type:Organization
Organization Name:MANN & MANN OPTOMETRISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:V
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-335-2022
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-0099
Mailing Address - Country:US
Mailing Address - Phone:402-335-2022
Mailing Address - Fax:402-335-3168
Practice Address - Street 1:131 N 3RD ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2491
Practice Address - Country:US
Practice Address - Phone:402-335-2022
Practice Address - Fax:402-335-3168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUSI2D67OtherMUTUAL OF OMAHA
NE06766OtherBLUE CROSS/BLUE SHEILD
NECS0141OtherRAILROAD MEDICARE PIN
2200006OtherUNITED HEALTH CARE
NE06766OtherBLUE CROSS/BLUE SHEILD
=========OtherVISION SERVICE PLAN (VSP)
NE092201Medicare PIN
NE=========00Medicaid
NET77020Medicare UPIN
NENA1048Medicare PIN