Provider Demographics
NPI:1427239672
Name:MODERN EYECARE INC.
Entity type:Organization
Organization Name:MODERN EYECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SCHOMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-483-2211
Mailing Address - Street 1:1650 S 70TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1569
Mailing Address - Country:US
Mailing Address - Phone:402-483-2211
Mailing Address - Fax:
Practice Address - Street 1:1650 S 70TH ST STE 201
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1569
Practice Address - Country:US
Practice Address - Phone:402-483-2211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0660860001Medicare NSC