Organization Name: | OPTICAL GALLERY LLC |
NPI Number: | 1952544215 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIMBERL;Y A RAYMOND (OPTOMETRIST AND OWNER) |
Mailing Address: | 1550 S Coddington Ave Suite V Lincoln |
State: | NE US |
Postal Code: | 685224402 |
Phone Number: | 4024700074 |
Fax Number: | 4022615855 |
NPI Enumeration Date: | 04/15/2009 |
NPI Last Update Date: | 03/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |