INTERNATIONAL EYECARE CENTER, INC. (NPI# 1740461979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740461979 |
| Entity Type | Organization |
| Organization Name | INTERNATIONAL EYECARE CENTER, INC. |
| Other Organization Name | MALBAR VISION |
| Practice Address |
8102 S 84th St Lavista NE 68128-3305 |
| Mailing Address |
409 N 78th St Omaha NE 68114-3638 |
| Practice Telephone | 4023395550 |
| Practice Fax Number | 4023395554 |
| Mailing Telephone | 4023934500 |
| Mailing Fax Number | 4023937457 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2020-03-03 |
| Authorized Official Name | CATHY LEE SHORT (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 6184629818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 470486594 | NE | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 47048659409 | 05 |
| Other Name | Type Code |
|---|---|
| Malbar Vision | Doing Business As Name - Organization |
| Malbar Vision Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154895621 | International Eyecare Center, Inc. | Optometrist | 16016 Evans St Ste 101, Omaha, NE 68116-6457 | 2019-01-17 |
| 1376542787 | International Eyecare Center, Inc. | Optometrist | 409 N 78th St, Omaha, NE 68114-3638 | 2005-07-18 |
| 1215378963 | International Eyecare Center, Inc. | Eyewear Supplier (Equipment, not the service) | 3201 Highway 61, Suite A, Hannibal, MO 63401-6578 | 2013-07-10 |
| 1467738724 | International Eyecare Center, Inc. | Eyewear Supplier (Equipment, not the service) | 450 E Sigler Ave, Memphis, MO 63555-1726 | 2011-10-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | INTERNATIONAL EYECARE CENTER, INC. | 4835 Lbj Fwy. Ste 850, Dallas, TX 75244 |
| Street Address |
8102 S 84TH ST |
| City | LAVISTA |
| State | NE |
| Zip Code | 68128-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730118233 | Donald R Krysl | Optometrist | 8102 S 84th St, Lavista, NE 68128 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589746 | Ruth Ann Moses | Prevention Professional | 7030 S 110th St, Omaha, NE 68128 | 2018-08-29 |
| 1972945897 | Jenna Leigh Graeve | Physical Therapist | 7040 S 114th St Plz Apt 203, La Vista, NE 68128 | 2013-07-19 |
| 1245564012 | Optum Infusion Services 302, LLC | Pharmacy | 8720 South 114th Street, Suite 106, La Vista, NE 68128 | 2009-09-28 |
| 1730385709 | Granville Assisted Living, LLC | Point of Service | 5807 Granville Parkway, La Vista, NE 68128 | 2007-06-26 |
| 1629160072 | Rachel L. Mccann | Pediatrics | 9801 Giles Road, Suite 1, La Vista, NE 68128 | 2006-09-29 |
| 1073030607 | September Leigh Wanzenried | Family Medicine | 6901 S 84th St, La Vista, NE 68128 | 2017-08-24 |
| 1518312719 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1245685445 | Costco Wholesale Corporation | Hearing Aid Equipment | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1386011971 | Kelsey Klatt | Occupational Therapist | 6960 S 110th St, La Vista, NE 68128 | 2015-08-31 |
| 1003299827 | Jordan Tichenor | Internal Medicine | 8604 Giles Rd, La Vista, NE 68128 | 2015-06-30 |
| Find all providers in zip 68128 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003462763 | Thundercloud Optical, LLC | Eyewear Supplier (Equipment, not the service) | 8838 Washington Cir, Omaha, NE 68127-4011 | 2019-08-16 |
| 1841856234 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2801 Pine Lake Rd Ste J, Lincoln, NE 68516-6041 | 2019-05-12 |
| 1659937027 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2802 S 143rd Plz, Omaha, NE 68144-5611 | 2019-05-11 |
| 1902462377 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1130 S 13th St Ste 200, Norfolk, NE 68701-5733 | 2019-05-11 |
| 1952967325 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1919 N Diers Ave Ste B, Grand Island, NE 68803-1284 | 2019-05-11 |
| 1760048136 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 848 Cornhusker Rd Ste 105, Bellevue, NE 68123-4433 | 2019-05-11 |
| 1578099024 | Walman Optical Company | Eyewear Supplier (Equipment, not the service) | 12240 Emmet St, Omaha, NE 68164-4265 | 2017-05-03 |
| 1679921720 | Statton Optical | Eyewear Supplier (Equipment, not the service) | 4645 Normal Blvd Ste 132, Lincoln, NE 68506-5823 | 2016-05-31 |
| 1477890937 | Arkfeld, Parson, Goldstein, PC | Eyewear Supplier (Equipment, not the service) | 450 Regency Pkwy, Suite 110, Omaha, NE 68114-3764 | 2013-01-03 |
| 1588950869 | Sutton Vision Center Inc | Eyewear Supplier (Equipment, not the service) | 103 N Saunders Ave, Sutton, NE 68979-2506 | 2011-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.