Provider Demographics
NPI:1841349909
Name:MCNEMAR OPTICAL, INC.
Entity type:Organization
Organization Name:MCNEMAR OPTICAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-488-3937
Mailing Address - Street 1:1756 W LANE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3311
Mailing Address - Country:US
Mailing Address - Phone:614-488-3937
Mailing Address - Fax:614-488-3102
Practice Address - Street 1:1756 W LANE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3311
Practice Address - Country:US
Practice Address - Phone:614-488-3937
Practice Address - Fax:614-488-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4854350001Medicare NSC
OH4854350001Medicare ID - Type Unspecified