Lake Avenue Eyecare Llc in Gothenburg - Eyewear Supplier
Lake Avenue Eyecare Llc - NPI 1396932430
Lake Avenue Eyecare Llc is a Eyewear Supplier in Gothenburg, Nebraska. Lake Avenue Eyecare Llc practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Lake Avenue Eyecare Llc is 1396932430. The last update date is 2022-10-27.
Lake Avenue Eyecare Llc's current location address is 829 Lake Ave, Gothenburg, Nebraska. You can contact this provider via phone number 3085373390 and fax number 3085373391. The mailing address for Lake Avenue Eyecare Llc is 829 Lake Ave, Gothenburg, Nebraska. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Avenue Eyecare Llc |
|---|---|
| Address | 829 Lake Ave, Gothenburg, Nebraska |
| Phone Number | 3085373390 |
| Fax Number | 3085373391 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Gosnell A John |
| Credentials | O.D. |
| Telephone Number | 3085373390 |
NPI Number Detail
| NPI Number | 1396932430 |
|---|---|
| Provider Enumeration Date | 2007-10-03 |
| Last Updated Date | 2022-10-27 |
Provider Mailing Address Detail
| Address | 829 Lake Ave |
|---|---|
| City | Gothenburg |
| State | Nebraska (NE) |
| Post Code | 691381943 |
| Phone Number | 3085373390 |
| Fax Number | 3085373391 |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
| Licence No | 1166 |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 240481 | MIDLANDS CHOICE | ||
| 6754 | BLUE CROSS BLUE SHIELDPIN | ||
| 10024987700 | NE | -- |
Post Comment/ Review Below
What is the Lake Avenue Eyecare Llc's 1396932430?
The Lake Avenue Eyecare Llc's NPI (National Provider Identifier) Number is 1396932430. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Lake Avenue Eyecare Llc's facilities are geographically located?
The facilities of Lake Avenue Eyecare Llc are physically situated at the following location: 829 Lake Ave, Gothenburg, NE, 691381943.
What is Lake Avenue Eyecare Llc's area of expertise and its corresponding taxonomy classification?
The Lake Avenue Eyecare Llc's field of specialization is Eyewear Supplier, and it falls under the taxonomy code 332H00000X, which categorizes healthcare providers based on their areas of practice.
On what date did Lake Avenue Eyecare Llc receive its 1396932430 assignment from the Centers for Medicare & Medicaid Services?
The Lake Avenue Eyecare Llc was assigned its 1396932430 on 2007-10-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Lake Avenue Eyecare Llc most recently updated or revised?
The information pertaining to Lake Avenue Eyecare Llc, including its address, specialty, and other relevant details, was last updated or revised on 2022-10-27.
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