Provider Demographics
NPI:1154335065
Name:EYECARE SPECIALTIES, PC OF LINCOLN
Entity type:Organization
Organization Name:EYECARE SPECIALTIES, PC OF LINCOLN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-420-2020
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68026-0072
Mailing Address - Country:US
Mailing Address - Phone:402-727-9050
Mailing Address - Fax:402-727-5625
Practice Address - Street 1:1445 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3534
Practice Address - Country:US
Practice Address - Phone:402-727-9220
Practice Address - Fax:402-727-5625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE786152W00000X
NE780152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0241790002Medicare NSC
NE094101Medicare PIN