MEDICARE: MANN & MANN OPTOMETRISTS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	921	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CS0141	OTHER	NE	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GUSI2D67	OTHER		MUTUAL OF OMAHA
2	06766	OTHER	NE	BLUE CROSS/BLUE SHEILD
4	2200006	OTHER		UNITED HEALTH CARE

General Provider Information

NPI Number	:	1740275163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANN & MANN OPTOMETRISTS PC

Provider Business Mailing Address
First Line	:	PO BOX 99
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-0099
Country	:	US
Telephone Number	:	402-335-2022
Fax Number	:	402-335-3168

Provider Business Practice Location Address
First Line	:	131 N 3RD ST
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-2491
Country	:	US
Telephone Number	:	402-335-2022
Fax Number	:	402-335-3168

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GREGORY V MANN
Credential	:	OD
Telephone Number	:	402-335-2022

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	01/03/2012

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Directions to “MANN & MANN OPTOMETRISTS PC ” Practice Location

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