Healthcare Provider Details

I. General information

NPI: 1336444744
Provider Name (Legal Business Name): ELAHI EYE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 MCMILLAN RD
WEST MONROE LA
71291-8316
US

IV. Provider business mailing address

303 MCMILLAN ROAD, SUITE A SUITE A
WEST MONROE LA
71291-8163
US

V. Phone/Fax

Practice location:
  • Phone: 318-387-7257
  • Fax: 318-325-7034
Mailing address:
  • Phone: 318-387-7257
  • Fax: 318-325-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MERCY ELAHI-NEAL
Title or Position: PRESIDENT
Credential: O.D.
Phone: 318-680-1916