is a Eyewear Supplier in Omaha, Nebraska. practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for is 1518919786. The last update date is .
's current location address is 5646 N 90th St, Omaha, Nebraska. You can contact this provider via phone number 4025721604. The mailing address for is 5646 N 90th St, Omaha, Nebraska. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 5646 N 90th St, Omaha, Nebraska |
| Phone Number | 4025721604 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1518919786 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 5646 N 90th St |
|---|---|
| City | Omaha |
| State | Nebraska (NE) |
| Post Code | 681341808 |
| Phone Number | 4025721604 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
|
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 |
|---|---|---|---|
| 35862 | DAVIS | ||
| 41098505412 | NE | -- | |
| 14046 | VIP | ||
| 35505 | AVESIS | ||
| 268733 | MEDICARE | ||
| 7120 | BLOCK | ||
| CP2230-32 | EYEMED | ||
| 17886 | MEDICARE |
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