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Marion Eye Centers LTD.

Organization Active NPI Durable Medical Equipment & Medical Supplies · West Frankfort, IL

NPI 1891850467 · NPPES record last updated Aug 7, 2017

Key facts

NPI
1891850467
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
036051996 (IL)
Legal business name
MARION EYE CENTERS LTD.
Practice address
909 W Main St
West Frankfort, IL 62896-2209
Phone
(618) 937-2442
Fax
(618) 932-2875
NPI assigned
Dec 26, 2006
Organization subpart
No

Authorized official

Name
Maqbool Ahmad, M.D.
Title
President Owner
Phone
(618) 993-5686

Corporate family (same tax ID) 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Marion Eye Centers LTD
909 W Main St, West Frankfort, IL 62896-2209 · (618) 937-2442		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Jan 1, 1995

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930052628 IL DME Supplier - Physician - Ophthalmology
DME Supplier - Physician - Optometrist		 3072426774 Practice locations: West Frankfort, IL

National Provider Directory

Tax ID family
Marion Eye Centers Inc (29 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 036051996 IL Yes

Addresses

Primary practice location

909 W Main St
West Frankfort, IL 62896-2209

Mailing address

1200 W Deyoung St
P.O. Box 1178
Marion, IL 62959-4437
Phone (618) 993-5686

Other identifiers

IdentifierTypeStateIssuer
036051996MedicaidIL
203169800MedicaidMO

Other names

  • Marion Eye Centers, Ltd. Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 7, 2017.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502064000000",
    "number": "1891850467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W DEYOUNG ST",
            "address_2": "P.O. BOX 1178",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594437",
            "telephone_number": "618-993-5686",
            "fax_number": "618-997-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962209",
            "telephone_number": "618-937-2442",
            "fax_number": "618-932-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION EYE CENTERS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2017-08-07",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "MAQBOOL",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "618-993-5686",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036051996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051996",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203169800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marion Eye Centers, Ltd.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Frankfort, IL

All providers in West Frankfort, IL · Durable Medical Equipment & Medical Supplies in Illinois

Sources for this page

Verify at the official NPI Registry.