Healthcare Provider Details

I. General information

NPI: 1942519681
Provider Name (Legal Business Name): BENDER EYECARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9925 HAYNES BRIDGE RD SUITE 710A
JOHNS CREEK GA
30022-8532
US

IV. Provider business mailing address

9925 HAYNES BRIDGE RD SUITE 710A
JOHNS CREEK GA
30022-8532
US

V. Phone/Fax

Practice location:
  • Phone: 770-740-2000
  • Fax:
Mailing address:
  • Phone: 770-740-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateGA

VIII. Authorized Official

Name: ALAN HENRY BENDER
Title or Position: VP
Credential:
Phone: 770-740-2000